Prevalence and co-occurrence of cognitive impairment in children and young people up to 12-months post infection with SARS-CoV-2 (Omicron variant)

• Published in: Brain, behavior, and immunity Vol. 119; pp. 989 - 994
• Main Authors: Foret-Bruno, Paul, Shafran, Roz, Stephenson, Terence, Nugawela, Manjula D, Chan, Dennis, Ladhani, Shamez, McOwat, Kelsey, Mensah, Anna, Simmons, Ruth, Fox Smith, Lana, D'oelsnitz, Anaïs, Xu, Laila, Dalrymple, Emma, Heyman, Isobel, Ford, Tamsin, Segal, Terry, Chalder, Trudie, Rojas, Natalia, Pinto Pereira, Snehal M
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.07.2024
• Subjects: Brain fog; Children; Cognitive impairment; long Covid; Omicron; Post Covid-19 condition; Prospective; Young people; Young people; Prospective; Brain fog; Post Covid-19 condition; Omicron; long Covid; Children; Cognitive impairment
• ISSN: 0889-1591; 1090-2139
• DOI: 10.1016/j.bbi.2024.05.001

•12 months after SARS-CoV-2 infection, around 7 % of children and young people report ‘brain fog’ i.e., cognitive impairment.•2.4% of children and young people experienced persistent cognitive impairment at 3-, 6- and 12-months after SARS-CoV-2 infection.•12 months after SARS-CoV-2 infection, more females, white ethnicities, and older at the time of first infection, children and young people reported cognitive impairment.•Cognitive impairment co-occurs with poorer mental health, fatigue and sleep problems. Cognitive impairment is often reported after SARS-CoV-2 infection, yet evidence gaps remain. We aimed to (i) report the prevalence and characteristics of children and young people (CYP) reporting “brain fog” (i.e., cognitive impairment) 12-months post PCR-proven SARS-CoV-2 infection and determine whether differences by infection status exist and (ii) explore the prevalence of CYP experiencing cognitive impairment over a 12-month period post-infection and investigate the relationship between cognitive impairment and poor mental health and well-being, mental fatigue and sleep problems. The Omicron CLoCk sub-study, set up in January 2022, collected data on first-time PCR-test-positive and PCR-proven reinfected CYP at time of testing and at 3-, 6- and 12-months post-testing. We describe the prevalence of cognitive impairment at 12-months, indicating when it was first reported. We characterise CYP experiencing cognitive impairment and use chi-squared tests to determine whether cognitive impairment prevalence varied by infection status. We explore the relationship between cognitive impairment and poor mental health and well-being, mental fatigue and trouble sleeping using validated scales. We examine associations at 3-, 6- and 12-months post-testing by infection status using Mann-Whitney U and chi-square tests. At 12-months post-testing, 7.0 % (24/345) of first-positives and 7.5 % (27/360) of reinfected CYP experienced cognitive impairment with no difference between infection-status groups (p = 0.78). The majority of these CYP experienced cognitive impairment for the first time at either time of testing or 3-months post-test (no difference between the infection-status groups; p = 0.60). 70.8 % of first-positives experiencing cognitive impairment at 12-months, were 15-to-17-years-old as were 33.3 % of reinfected CYP experiencing cognitive impairment (p < 0.01). Consistently at all time points post-testing, CYP experiencing cognitive impairment were more likely to score higher on all Strengths and Difficulties Questionnaire subscales, higher on the Chalder Fatigue sub-scale for mental fatigue, lower on the Short Warwick-Edinburgh Mental Wellbeing Scale and report more trouble sleeping. CYP have a fluctuating experience of cognitive impairment by 12-months post SARS-CoV-2-infection. Cognitive impairment is consistently correlated with poorer sleep, behavioural and emotional functioning over a 12-month period. Clinicians should be aware of cognitive impairment post-infection and its co-occurring nature with poorer sleep, behavioural and mental health symptoms.