Publication date: Jul 08, 2025
COVID-19 may have long lasting cognitive consequences. Studies with a follow-up longer than 1 year after infection are lacking. This study presents the prevalence of cognitive impairment 2 years after SARS-CoV-2 infection in survivors of the first year of the pandemic and comparison groups matched 1:1 for sex, age, and level of care. Users of the Local Health Unit of Matosinhos (comprising almost all citizens of the municipality) were retrospectively selected according to hospitalization and SARS-CoV-2 infection between March 2020 and February 2021: group #1, hospitalized for COVID-19 (n = 101); group #2, hospitalized, uninfected (n = 87); group #3, non-hospitalized, infected (n = 252); group #4, non-hospitalized, uninfected (n = 258). Between July 2022 and October 2023, all participants completed the Montreal Cognitive Assessment. Those with a score below 1. 5 SD of age- and education-specific norms (n = 279) were invited for a comprehensive neuropsychological assessment to identify cognitive impairment. The prevalence of cognitive impairment was higher in group #1 than #2 (19. 1% vs. 6. 8%; adjusted OR 5. 41, 95% CI 1. 54, 19. 03) and in group #3 than #4 (10. 7% vs. 3. 2%; adjusted OR 3. 27, 95% CI 1. 23, 8. 67). These results suggest that specific care to timely diagnose and treat cognitive impairment is needed for COVID-19 survivors of the first year of the pandemic.