Neurobiological changes associated with reduced neurocognitive performance: A systematic review on post-COVID sequelae in adults

Resumen

Background: Recent estimates suggest that at least 65 million individuals worldwide have experienced post-COVID sequelae, with neurocognitive impairments among the most prevalent. Aim: To synthesize results about neurobiological findings associated with neurocognitive difficulties in post-COVID adult patients, as reported in the scientific literature. Methods: A systematic review was conducted according to PRISMA guidelines using Web of Science, PubMed, and Scopus databases. Twenty-six scientific articles meeting the inclusion criteria were analyzed. Vote counting based on statistical significance was employed as a synthesis method. Results: In most of the included articles with significant results [87.5%; n =14] alterations of at least one neurocognitive domain in post-COVID patients are described. In 15 of 16 studies describing significant associations, neuropathological changes are confirmed among patients. Most [94%] studies reporting associations found a statistical significance between diminished neurocognitive performances and neurobiology. Particularly notable is the association between lower performance in global cognition and neuropathological findings in brain anatomy (e.g. atrophy, tissue damage, ischemia). Conclusions: The analysis presented in this review offers relevant background to inform policy decisions regarding the neurocognitive sequelae of COVID-19 and supports clinical decision-making for professionals caring for patients with this profile.