Peer-reviewed article
Associations between subjective cognitive difficulties, cognitive test performance, psychiatric symptoms, and quality of life in pediatric long COVID.
Audrey Davis, Gray Vargas, Kathleen Parker, Laura A Malone, Kavita D Nadendla et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study examined how children and adolescents with long COVID experience cognitive difficulties and how these affect their quality of life. The researchers tested 82 young patients aged 6-19 years using cognitive tests and quality-of-life measures. Children reported very poor quality of life, and their own perception of having cognitive problems was a strong predictor of lower quality of life, even more so than the results of formal cognitive testing.
Key points
- Pediatric long COVID patients reported very low overall quality of life (mean 52.41), comparable to those with other major chronic health conditions
- Subjective cognitive difficulties significantly predicted lower quality of life even after controlling for psychiatric symptoms
- Cognitive test performance on specific domains (intellectual functioning, memory, attention, processing speed, executive function) did not significantly determine quality of life
- The study included 82 pediatric patients (mean age 14.52 years) referred for neuropsychological evaluation
- Screening should focus on self-reported cognitive impairment rather than relying solely on formal cognitive testing or mental health assessment
Limitations
The study is retrospective and observational, examining only associations rather than causal relationships. The sample comprises only patients referred to a specialty Post-COVID clinic, which may not represent all children with long COVID, and the country/countries where the study was conducted are not specified in the provided metadata.
Abstract
Objective: This retrospective study examined the associations between subjective cognitive difficulties, performance scores on standardized cognitive tests, and quality of life (QoL) among pediatric patients with long COVID. Method: This study included 82 pediatric patients with long COVID referred for a neuropsychological evaluation by a specialty pediatric Post-COVID clinic (50 F, Mage = 14.52 years, SD = 3.04, range = 6-19). Patients completed standardized neuropsychological assessments of intellectual functioning, learning/memory, working memory, auditory attention, processing speed, executive function, and performance validity, as well as the Pediatric Quality of Life Inventory (PedsQLTM). Other outcomes of interest included subjective cognitive impairment and psychiatric symptoms. Relationships between subjective cognitive difficulties and cognitive performance on QoL were analyzed using hierarchical multiple linear regressions, with COVID course factors and psychiatric symptoms as covariates. Results: Our pediatric cohort reported very low overall QoL (M = 52.41, SD = 16.95), with the average score surpassing the published clinical cutoff for children with major chronic health conditions. Subjective cognitive difficulties significantly predicted lower QoL, even after controlling for psychiatric symptoms. Cognitive test performance on any domain did not significantly determine QoL. Conclusions: These findings offer initial support that subjective cognitive difficulties, but not cognitive test performance, significantly correlate with lower QoL in pediatric patients with long COVID. The results highlight the importance of screening for perceived subjective cognitive impairment beyond mental health screening in youth with long COVID. Treatment and school planning for children with long COVID should consider self-reported cognitive difficulties and psychological health and how these impact their daily functioning across home, school, and social settings.