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Abstract
Long COVID is associated with neurological and neuropsychiatric manifestations. We conducted an observational study on 97 patients with prior SARS-CoV-2 infection and persisting cognitive complaints that presented to the University Health Network Memory Clinic between October 2020 and December 2021. We assessed the main effects of sex, age, and their interaction on COVID-19 symptoms and outcomes. We also examined the relative contribution of demographics and acute COVID-19 presentation (assessed retrospectively) on persistent neurological symptoms and cognition. Among our cohort, males had higher hospitalization rates than females during the acute COVID-19 illness (18/35 (51%) vs. 15/62 (24%); P = .009). Abnormal scores on cognitive assessments post-COVID were associated with older age (AOR = 0.84; 95% CI 0.74–0.93) and brain fog during initial illness (AOR = 8.80; 95% CI 1.76–65.13). Female sex (ARR = 1.42; 95% CI 1.09–1.87) and acute shortness of breath (ARR = 1.41; 95% CI 1.09–1.84) were associated with a higher risk of experiencing more persistent short-term memory symptoms. Female sex was the only predictor associated with persistent executive dysfunction (ARR = 1.39; 95% CI 1.12–1.76) and neurological symptoms (ARR = 1.66; 95% CI 1.19–2.36). Sex differences were evident in presentations and cognitive outcomes in patients with long COVID.
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1 University of Toronto, Tanz Centre for Research in Neurodegenerative Diseases, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); University of Toronto, Institute of Medical Science, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); University Health Network, Division of Neurology, Toronto Western Hospital, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428); University Health Network, Krembil Research Institute, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428)
2 University Health Network, Division of Neurology, Toronto Western Hospital, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428); University Health Network, Krembil Research Institute, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428)
3 University Health Network, Division of Neurology, Toronto Western Hospital, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428); University Health Network, Krembil Research Institute, Toronto, Canada (GRID:grid.231844.8) (ISNI:0000 0004 0474 0428); Kuwait Institution for Medical Specialty (KIMS), Internal Medicine Board, Andalous, Kuwait (GRID:grid.488980.5) (ISNI:0000 0000 9894 6494); McMaster University, Geriatric Medicine, Hamilton, Canada (GRID:grid.25073.33) (ISNI:0000 0004 1936 8227)
4 University of Toronto, Institute of Medical Science, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); University of Toronto, Interdepartmental Division of Critical Care Medicine, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); University of Toronto, Institute of Health Policy, Management and Evaluation, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); University of Toronto, Toronto General Hospital Research Institute, University Health Network, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938)
5 University of Toronto, Institute of Medical Science, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); University of Toronto, Institute of Health Policy, Management and Evaluation, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938); University of Toronto, Toronto General Hospital Research Institute, University Health Network, Toronto, Canada (GRID:grid.17063.33) (ISNI:0000 0001 2157 2938)