Long-term Impact of COVID-19 on Cognition and Mental Health in an Indian Cohort

Long-term cognitive effects of COVID-19 remain poorly characterized in South Asian populations. We assessed 201 Indian adults at least six months after infection using standardized tests of working memory, selective attention, and pattern separation, alongside validated mental-health scales. Disease severity was defined clinically rather than by hospitalization, capturing individuals who experienced severe illness outside hospital care. Those with moderate-to-severe COVID-19 showed pronounced working-memory deficits compared with mildly infected and uninfected controls, while selective attention and pattern separation were comparable across groups. Vaccination at the time of infection predicted better pattern separation, suggesting selective hippocampal protection. Notably, nearly all participants with moderate-to-severe illness reported a complete recovery despite continuing to exhibit measurable cognitive deficits. However, we did not observe any robust differences in affect or in the propensity toward depression and anxiety. Taken together, our findings demonstrate that hospitalization is an inadequate proxy for disease severity and that subjective recovery is not an appropriate yardstick for assessing Long-COVID, underscoring the need for context-sensitive, population-based assessments of post-COVID sequelae.