Neuropsychology of COVID-19: Anticipated Cognitive and Mental Health Outcomes

Objective: Discuss anticipated patterns of cognitive and emotional dysfunction, prognostic indicators, and treatment considerations based on review of (a) neuroinvasive properties of prior human coronaviruses and (b) extensively researched disorders which share similar neurological mechanisms. Method: A web-based comprehensive search of peer-reviewed journals was conducted based on a variety of key terms (and variants of) including coronavirus, neuroinvasion, cognitive dysfunction, viral pandemics, respiratory illness, critical illness, and metabolic disease. Articles were chosen based on relevance to the current topic and ability to provide unique thematic information. Historical articles were included if these added scientific merit to recent literature. Review of information in widely disseminated news articles was followed-up with direct review of cited scientific literature. Databases searched included Google Scholar, PubMed, and Ovid Medline. Results: Based on neuroinvasive properties of prior coronaviruses and existing research on similar neurophysiological conditions with detrimental cognitive effects, COVID-19-especially those with severe symptoms-are at risk for cognitive decline and significant psychiatric/behavioral sequela. Conclusions: There are few studies examining cognitive outcomes in COVID-19. This review argues that neuropsychological sequelae are to be expected in patients with COVID-19. Considerations for clinicians working with this unique population are discussed. Key Points Question: There is limited research describing cognitive and psychiatric outcomes in COVID-19 patients. Findings: We reviewed available literature from prior pandemics, emerging COVID-19 research, and studies describing outcomes in similar medical conditions to hypothesize concerns when working with this population. Importance: Based on existing literature, we anticipate a wide range of cognitive and psychiatric symptoms in COVID-19 patients. Next Steps: Neuropsychologists play a vital role in comprehensive care for these patients and should be included on interdisciplinary treatment teams. Longitudinal data will help clarify risk of cognitive and psychiatric sequalae among COVID-19 patients.