Improved Outcomes Online test to validate long-covid brain fog

We published a paper in NEJM, with accompanying editorial, showing a measurable cognitive deficit in people with a history of SARS-CoV-2 infection, more pronounced in people with Long COVID and those who had been in intensive care. The paper has had substantial interest with an altmetric attention score of 3883 (including coverage in 173 news outlets, >6500 social media posts) and 87 citations. This has drawn attention to the impact of SARS-CoV-2 infection on cognition even in apparently mild cases, and made this an important focus of research.

This has benefited patients who have reported that the paper validated their experience and helped them access support by showing the scientific evidence: “I found the (cognitive) paper extremely validating. It helped me in that ‘brain fog’ is a very woolly term which I now have language for. It also helped me to explain the scale of this problem, and to voice the challenges I face with this, backed by science, to my employer”. (person with Long Covid writing to Long Covid Support).

The online methods used to assess cognition in this study have potential to improve early diagnosis of cognitive decline through a low-cost assessment which could be done repeatedly. The REACT study will provide longitudinal data on a substantial number of people which can be linked to health outcomes and therefore may provide evidence for the validity of these tests.