Publication date: Aug 15, 2025

Long-term consequences of COVID-19 seem to persist several years after initial infection; however, it is still unknown whether these consequences differ from those occurring after hospitalization for similar diseases and if they remain stable, improve, or worsen over time. This is a prospective cohort study assessing 36-month follow-up of individuals previously monitored up to 18 months post-hospitalization. We included COVID-19 patients; hospitalized controls admitted for pneumonia, myocardial infarction or conditions requiring intensive care admission; and healthy controls. The hospitalized groups were admitted between March 1, 2020, and June 30, 2021, at two academic hospitals in Copenhagen. All participants were examined in-person between October 2023 and July 2024. We investigated 242 participants. Eighty-four hospitalized COVID-19 patients (mean [SD] age 62 [12]; 39 females [46 %]), 80 hospitalized controls (mean age, 65 [11]; 30 females [38 %]), and 78 healthy controls (mean age, 65 [14]; 45 females [58 %]). Compared to the healthy controls, COVID-19 patients had poorer SCIP scores (estimated mean: 68. 0 [95 %CI, 65. 6-70. 5] vs 74. 4 [95 %CI, 71. 6-77. 2]) and non-significantly higher anxiety, depression, and neurological scores. COVID-19 patients performed comparably to hospitalized controls in all outcomes (all p > . 06). Cognitive function improved over time among both COVID-19 and hospitalized controls, while mental-health improved mainly in COVID-19 patients. This study shows comparable brain function impairments in COVID-19 patients and hospitalized controls 36 months post-hospitalization, with gradual improvement over time. These findings are relevant for guiding patients with long-lasting symptoms after critical illness.

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