- Apple, Alexandra C;
- Oddi, Alexis;
- Peluso, Michael J;
- Asken, Breton M;
- Henrich, Timothy J;
- Kelly, J Daniel;
- Pleasure, Samuel J;
- Deeks, Steven G;
- Allen, Isabel Elaine;
- Martin, Jeffrey N;
- Ndhlovu, Lishomwa C;
- Miller, Bruce L;
- Stephens, Melanie L;
- Hellmuth, Joanna
Cognitive post-acute sequelae of SARS-CoV-2 (PASC) can occur after mild COVID-19. Detailed clinical characterizations may inform pathogenesis. We evaluated 22 adults reporting cognitive PASC and 10 not reporting cognitive symptoms after mild SARS-CoV-2 infection through structured interviews, neuropsychological testing, and optional cerebrospinal fluid (CSF) evaluations (53%). Delayed onset of cognitive PASC occurred in 43% and associated with younger age. Cognitive PASC participants had a higher number of pre-existing cognitive risk factors (2.5 vs. 0; p = 0.03) and higher proportion with abnormal CSF findings (77% vs. 0%; p = 0.01) versus controls. Cognitive risk factors and immunologic mechanisms may contribute to cognitive PASC pathogenesis.