Cognitive phenotypes and neuropsychological trajectories in post-COVID-19 syndrome: a 12-month follow-up study

Post-COVID-19 syndrome (PCS) has been associated with cognitive difficulties, particularly in attention, processing speed, memory, and executive functions, but longitudinal evidence based on comprehensive neuropsychological assessment remains limited. This study examined the one-year evolution of neuropsychological performance and cognitive phenotypes in 92 patients with PCS who had participated in a previous assessment. Pre-post changes were analysed using Wilcoxon signed-rank tests with false discovery rate correction.

Cognitive phenotypes were characterized in the complete phenotype sample (N = 83) using a domain-based approach derived from the IC-CoDi-COVID criteria, with two representative tests for each cognitive domain and two impairment cutoffs: ≤ -1 SD and ≤ -1.5 SD. Significant improvements were observed mainly in verbal and visual memory, matrix reasoning, inhibitory control, and action processing (fluency and naming), whereas attention and processing speed measures remained largely stable. Phenotype analyses showed a shift toward less impaired cognitive profiles at follow-up.

Normal cognition increased from 65.1% to 77.1% under the ≤ -1 SD criterion and from 83.1% to 86.7% under the ≤ -1.5 SD criterion. Impaired phenotypes were primarily driven by attention/processing speed. These findings suggest partial cognitive recovery in PCS, alongside persistent domain-specific cognitive vulnerability, particularly in attention and processing speed.

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Departamento de Psicología, Universidad de Oviedo, Oviedo, Spain Elena Herrera, Ainhoa Señoráns, Arrate Barrenechea, María del Carmen Pérez-Sánchez & María González-Nosti The authors declare no competing interests. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/. Herrera, E., Señoráns, A., Barrenechea, A. et al.