COVID-19 survivors may experience a wide range of chronic cognitive symptoms for months or years as part of post-COVID-19 conditions (PCC). To date, there is no definitive objective cognitive marker for PCC. We hypothesised that a key common deficit in people with PCC might be generalised cognitive slowing. To examine cognitive slowing, patients with PCC completed two short web-based cognitive tasks, Simple Reaction Time (SRT) and Number Vigilance Test (NVT). 270 patients diagnosed with PCC at two different clinics in UK and Germany were compared to two control groups: individuals who contracted COVID-19 before but did not experience PCC after recovery (No-PCC group) and uninfected individuals (No-COVID group). All patients with PCC completed the study between May 18, 2021 and July 4, 2023 in Jena University Hospital, Jena, Germany and Long COVID clinic, Oxford, UK. We identified pronounced cognitive slowing in patients with PCC, which distinguished them from age-matched healthy individuals who previously had symptomatic COVID-19 but did not manifest PCC. Cognitive slowing was evident even on a 30-s task measuring simple reaction time (SRT), with patients with PCC responding to stimuli ∼3 standard deviations slower than healthy controls. 53.5% of patients with PCC's response speed was slower than 2 standard deviations from the control mean, indicating a high prevalence of cognitive slowing in PCC. This finding was replicated across two clinic samples in Germany and the UK. Comorbidities such as fatigue, depression, anxiety, sleep disturbance, and post-traumatic stress disorder did not account for the extent of cognitive slowing in patients with PCC. Furthermore, cognitive slowing on the SRT was highly correlated with the poor performance of patients with PCC on the NVT measure of sustained attention. Together, these results robustly demonstrate pronounced cognitive slowing in people with PCC, which distinguishes them from age-matched healthy individuals who previously had symptomatic COVID-19 but did not manifest PCC. This might be an important factor contributing to some of the cognitive impairments reported in patients with PCC. Wellcome Trust (206330/Z/17/Z), NIHR Oxford Health Biomedical Research Centre, the Thüringer Aufbaubank (2021 FGI 0060), German Forschungsgemeinschaft (DFG, FI 1424/2-1) and the Horizon 2020 Framework Programme of the European Union (ITN SmartAge, H2020-MSCA-ITN-2019-859890).

The present study investigated the usability of whole and partial report of briefly displayed letter arrays as a diagnostic tool for the assessment of attentional functions. The tool is based on Bundesen's (1990, 1998, 2002; Bundesen et al., 2005) theory of visual attention (TVA), which assumes four separable attentional components: processing speed, working memory storage capacity, spatial distribution of attention, and top-down control. A number of studies (Duncan et al., 1999; Habekost & Bundesen, 2003; Peers et al., 2005) have already demonstrated the clinical relevance of these parameters. The present study was designed to examine whether (a) a shortened procedure bears sufficient accuracy and reliability, (b) whether the procedures reveal attentional constructs with clinical relevance, and (c) whether the mathematically independent parameters are also empirically independent. In a sample of 35 young healthy subjects, we found high intraparameter correlations between full- and short-length tests and sufficient internal consistencies as measured via a bootstrapping method. The clinical relevance of the TVA parameters was demonstrated by significant correlations with established clinical tests measuring similar constructs. The empirical independence of the four TVA parameters is suggested by nonsignificant or, in the case of processing speed and working memory storage capacity, only modest correlations between the parameter values. (JINS, 2005, 11, 832–842.)