Abstract
INTRODUCTION: The effects of COVID-19 extend beyond acute illness, with many survivors experiencing persistent symptoms. This study aimed to determine the frequency and contributing factors of cognitive impairment and other neurological symptoms in COVID-19 survivors four weeks after diagnosis, compared with healthy controls during the pandemic's fourth wave. METHODS: A multicenter case-control study was conducted involving 176 COVID-19 survivors, diagnosed four weeks prior, and 92 healthy controls from Algeria, Egypt, and Libya. Data were collected through interviews using a structured, validated questionnaire administered by a trained physician. RESULTS: Post-COVID-19 survivors exhibited significant cognitive deficits, chronic fatigue, and sensory impairments (including loss of appetite, taste, smell, and hearing). Cognitive impairment (Montreal Cognitive Assessment [MoCA] score <26) was observed in 57 participants (32.3%), with those affected being older (44.6 ± 16.9 years, P < 0.001) and consuming more junk food (8.6 ± 3.3 servings, P = 0.04). Cognitive disorders were more frequent among females (83.3%), smokers (57.9%), highly educated individuals (76.5%), and married participants (63.7%). DISCUSSION: The study revealed a substantial burden of cognitive and sensory impairments in post-COVID-19 patients, supporting global observations and emphasizing the need for early screening and lifestyle interventions. The reliance on self-reported data and a case-control design limit causal inference. CONCLUSION: Post-COVID-19 survivors showed significant cognitive deficits, fatigue, and sensory impairments. Cognitive impairment was present in 32.3%, with higher prevalence in females, smokers, highly educated individuals, and married participants.