Cognitive Stressors and COVID-19 Infection: A Longitudinal Survey

Objectives: Survey the prevalence of various stress-related factors among a sample of the US adult population over the course of 1 year to compare rates among those who reported ever receiving a positive COVID-19 test vs those who never received a positive test. Highlight the potential impact of these factors upon cognitive functioning during the COVID-19 pandemic. Methods: A US census, age-balanced sample of adults was recruited through an online survey platform and participated in three waves of surveys. In each wave, roughly 3 months apart, participants, blinded to the survey sponsor, completed surveys with demographic information and questions regarding mental health, physical health, and environmental factors which have been linked to cognitive health. Participants were also asked whether they had ever received a positive COVID-19 test. Results: A total of 4,905 respondents were included in the first wave, 3,940 were included in the second wave, and 3,157 respondents were included in the third wave. In the third wave of the survey the largest age group was those 30 to 39 years of age (33.7% of respondents; n=1,063/3,157). The majority of respondents reported that they had never tested positive for COVID-19 (87.2%; n=2,610/3,157). The rate of those who reported ever receiving a positive COVID-19 test result was 17.3% (n=547/3,157). Respondents who reported a positive test result were more likely to report experiencing anxious symptoms and depressive symptoms between the second and third surveys vs those who never received a positive test result (70.5% vs 47.5% and 66.5% vs 37.3%, respectively). Respondents who reported a positive test result were more likely to report receiving a formal diagnosis from a healthcare provider for a sleep-related disorder (53.7% vs 19.1%). Respondents who reported a positive test result were more likely to report experiencing “more” or “much more” concern vs those without a positive test result since the second survey in the following areas: affording housing (49.5% vs 25.3%); employment or potential job loss (33.6% vs 20.0%); and affording necessities like food and medicine (44.8% vs 27.6%). Conclusions: Survey respondents who reported receiving a positive COVID-19 test result vs those who did not had a higher prevalence of stressors known to affect cognitive functioning, including anxiety, depression, sleep troubles, and concerns over issues recognized as social determinants of health. Routine neurocognitive assessment in clinical practice may be an important tool clinicians can use to track the long-term effects of the COVID-19 pandemic on overall cognitive health, allowing them to intervene as needed.