Concentration, attention & memory - cognition problems with Long Covid

Long Covid can be accompanied by problems with concentration, attention, and memory. There are measures and exercises that can help.

Veröffentlicht am

8.7.2024

Zuletzt aktualisiert am

8.7.2024

Cognition describes the totality of all processes related to perception and cognition. It is also referred to as mental performance. Cognition includes, among other things, concentration, attention and memory.

In cognitive disorders, mental performance is temporarily or permanently impaired. Typical symptoms are forgetfulness, reduced attention, concentration problems, speech disorders, orientation problems or memory loss.

Cognitive impairment can accompany various chronic diseases - including Long Covid.

This article explains what cognition is, sheds light on cognitive problems in Long Covid patients and presents exercises that can help.

Cognition - mental performance

People perceive their surroundings through the five senses of sight, hearing, smell, taste and touch. The eyes, ears, nose, tongue and skin are sensory organs through which environmental stimuli are received and transmitted to the brain. Information processing begins.

Human information processing can be simplified into three steps:

  1. reception (perception)
  2. processing (understanding and interpretation)
  3. reaction (storage in the brain or action)

In principle, the short-term or working memory can only store around four blocks of information in parallel. This limits the amount of information that can be processed at the same time [1]. Due to these limited attention resources, people find it difficult to pursue several tasks or goals at the same time. This can lead to errors if the cognitive demands exceed capacity.

Cognitive problems — an unpleasant companion of Long Covid

Cognitive problems are a frequent companion of various chronic illnesses. Long Covid patients report concentration deficits and forgetfulness in particular:

  • 78% of Long Covid patients report difficulty concentrating and a shortened attention span [2]
  • 68% of Long Covid patients describe general forgetfulness and limitations in verbal memory [2]. Verbal memory or working memory describes the cognitive ability to briefly store and process verbal information.

Supplementary studies were undertaken to corroborate the subjective data with objective data. Researchers found that around 44-53% of Long Covid patients suffer from cognitive problems [3-7].

Short-term memory and attention were most frequently impaired.

Patients with Long Covid also show a strong cognitive slowdown in simple reaction time and sustained attention tasks compared to recovered corona patients who did not suffer from Long Covid [7].

The cognitive areas that were most affected in all studies were

  • memory (verbal memory, associative memory),
  • executive functions (working memory, cognitive flexibility, processing speed) and
  • attention.

Cognitive impairments often affect Long Covid patients. In particular, concentration, attention and memory performance may be impaired compared to before the coronavirus infection.

Exercises for cognitive impairment

If cognitive abilities are impaired, it is advisable to create a distraction-free environment and train mental performance.

Reduce distraction

Try to avoid unnecessary distractions such as loud noises. Use earplugs if necessary. Create a quiet and tidy workplace. This will prevent you from being distracted during an activity.‍

Plan activities and breaks

It can be harder to concentrate when you are exhausted or tired.

Therefore, try to schedule important tasks for the time of day when you have the most energy. For example, if you are fit in the morning and get tired during the day, schedule your most important tasks in the morning.

Take breaks in between to recover - and consciously plan these into your day too.‍

Time planning

Make a schedule for the next day or week. To do this, you can divide larger tasks into smaller steps and then plan the individual steps in advance. What do you need to do? How long will it take you? Which steps are the most important? When can you take breaks?‍

Realistic goals

If you set yourself specific and realistic goals, you will be more motivated to work on your tasks. For example, set yourself the goal of reading 5 pages of a book or writing a paragraph.‍

Incentives & rewards

It is important to reward yourself when you have achieved something. Be it a cup of coffee, a walk or your favourite meal. This also brings some variety into your everyday life.‍

Cognitive exercises

Carry out regular cognitive exercises to train your cognition.

Use puzzles, word and number games, and/or memory exercises.

Start with easy exercises and increase step by step when you have achieved success. It is important not to overstrain yourself. Failing an exercise or practising at the same level for several days can be frustrating, but is often unavoidable.

Cognition encompasses all processes of perception and cognition, such as concentration, attention and memory. In cognitive disorders, often also in Long Covid, this performance is impaired, which can lead to forgetfulness, concentration problems and memory loss.

Studies show that one in two or two out of three Long Covid patients suffer from cognitive impairment, particularly in short-term memory and attention.

To improve these, a distraction-free environment, planning activities and breaks, setting realistic goals, rewards and regular cognitive exercises such as puzzles and memory training can help.

[1] Morris AH. Human Cognitive Limitations. Broad, Consistent, Clinical Application of Physiological Principles Will Require Decision Support. Ann Am Thorac Soc. 2018 Feb; 15 (Suppl 1) :S53-S56. doi: 10.1513/annalsats.201706-449kv. PMID: 29461892; PMCID: PMC5822395.

[2] Garget J, University of Camebridge. Memory and concentration problems are common in long COVID and must not be ignored, say scientists. Retrieved on 20/06/24 at https://www.cam.ac.uk/stories/memory-long-COVID

[3] Miskowiak KW, Pedersen JK, Gunnarsson DV, et al. Cognitive Impairments Among Patients in a Long-COVID Clinic: Prevalence, Pattern and Relation to Illness Severity, Work Function and Quality of Life. J Affect Disord. 2023 Mar 1; 324:162-169. doi: 10.1016/j.jad.2022.12.122. Epub 2022 Dec 28. PMID: 36586593; PMCID: PMC9795797.

[4] Al-Aly Z, Roses, C.J. Long Covid and Impaired Cognition — More Evidence and More Work to Do. N Engl J Med 2024; 390:858-860. DOI: 10.1056/NEJME2400189

[5] Venkataramani V, Winkler F. Cognitive Deficits in Long Covid. N Engl J Med 2022; 387:1813-1815. DOI: 10.1056/nejmcibr2210069

[6] Guo P, Bellesteros AB, Yeung SP et al. COVCOG 2: Cognitive and Memory Deficits in Long COVID: A Second Publication From the COVID and Cognition Study. Front. Aging Neurosci., 17 March 2022 sec. Neurocognitive Aging and Behavior Volume 14 - 2022 | https://doi.org/10.3389/fnagi.2022.804937

[7] Zhao S, Martin EM, Reuken PA et al. Long COVID is associated with severe cognitive slowing: a multicentre cross-sectional study. eClinicalMedicine part of the LANCET Discovery Science VOLUME 68, 102434, FEBRUARY 2024 TO: https://doi.org/10.1016/j.eclinm.2024.102434