Cognitive Impairments in Two Samples of Individuals with ME/CFS and Long COVID: A Comparative Analysis, 2025, Sirotiak et al.

SNT Gatchaman

SNT Gatchaman

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Cognitive Impairments in Two Samples of Individuals with ME/CFS and Long COVID: A Comparative Analysis
Sirotiak, Zoe; Adamowicz, Jenna L.; Thomas, Emily B. K.

Cognitive impairments, including memory and concentration difficulties, are common in individuals with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and long COVID. These conditions frequently co-occur, but it remains unclear how cognitive difficulties differ between individuals with ME/CFS, long COVID, both, or neither. The purpose of this study was to examine cognitive impairment presence and type for individuals with and without these conditions. Data from the 2022 and 2023 National Health Interview Survey were analyzed.

Participants included 27,512 and 29,404 U.S. adults in 2022 and 2023, respectively. Survey weights and variance estimation variables were utilized and multivariate logistic regression models assessed the likelihood of cognitive difficulty, accounting for sociodemographics and shared variance.

Participants from both cohorts were primarily female, white, and non-Hispanic/Latine, with an average age of 48.1 years in both cohorts. ME/CFS (aOR 6.18; 95% CI 4.82–7.93; aOR 5.33; 95% CI 4.04–7.05) and long COVID (aOR 2.01; 95% CI 1.67–2.44; aOR 2.16; 95% CI 1.82–2.56) were significantly associated with reported cognitive difficulties, after controlling for the other condition and sociodemographic factors.

Individuals with ME/CFS, particularly those with comorbid long COVID, are especially prone to memory and concentration difficulties.

Link | PDF (Journal of Clinical Psychology in Medical Settings)
 
They introduced with —

ME/CFS describes a chronic, impairing condition characterized by overwhelming exhaustion, worsened symptoms following physical, mental, or emotional exertion, and unrefreshing sleep (Institute of Medicine, 2015a). ME/CFS has also been associated with a diverse array of symptoms, such as orthostatic intolerance, chronic pain, headaches, gastrointestinal disturbance, and cognitive difficulties (Carruthers et al., 2003, 2011; Institute of Medicine, 2015a, 2015b). Cognitive difficulties are among the most frequently endorsed symptoms among individuals with ME/CFS, with up to 88% of individuals affected noting memory or concentration problems (Aoun Sebaiti et al., 2022; Jason et al., 1999). Often reported subjectively, cognitive impairments n ME/CFS have also been demonstrated objectively through neurocognitive testing, with deficiencies noted in information processing tasks, attention, and working memory (Ocon, 2013). Of note, while often included as an additional symptom of ME/CFS across several case definitions (Carruthers et al., 2003, 2011; Institute of Medicine, 2015a), individuals can receive a ME/CFS diagnosis without the presence of cognitive impairments.
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Followed later by —

Although cognitive impairments have been noted among both ME/CFS and long COVID, it is unclear how these impairments may differ between individuals with either ME/ CFS, long COVID, or both conditions. Therefore, the purpose of this study was to establish the relative associations of ME/ CFS and long COVID and self-reported cognitive difficulties in two samples—the 2022 and 2023 National Health Interview Survey (NHIS) datasets—to see if findings would replicate.
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and —

Characteristics of cognitive impairments (self-reported memory and concentration difficulties) among individuals with these conditions will be investigated.
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SNT Gatchaman said:
Individuals with ME/CFS, particularly those with comorbid long COVID, are especially prone to memory and concentration difficulties.
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ME/CFS Skeptic said:
Cognitive symptoms are one of the required symptoms in many ME/CFS case definitions, so this seems like a circular argument.
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This is still interesting, as it seems like the combo of ME/CFS + LC gives more cognitive symptoms.
 
Utsikt said:
This is still interesting, as it seems like the combo of ME/CFS + LC gives more cognitive symptoms.
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I'm wouldn't be automatically sure of that, I don't think it follows directly. Here's my thinking:

I haven't read the study but whether it is interesting or even "true" depends fully on the definition of what ME/CFS with comobird LC is supposed to mean in this study context.

There's 4 scenarios here: You either have ME/CFS with no relation to Covid, you have had ME/CFS and develop Long-Covid on top of that (what that is supposed to mean is rather wishy washy and depends on the context), you have ME/CFS from Covid or you have Long-Covid without having ME/CFS.

The problem is for someone that already has ME/CFS to develop Long-Covid on top of that, means they will have to develop a new symptom or one of their existing symptoms have to worsen, which is the definition of Long-Covid. Since cognitive symptoms fits that bill you'd naturally expect this number to be higher (the same would apply to anosmia etc) without it necessarily being interesting but rather possibly being an artefact of the Long-Covid construct (a bit similar to how more Covid infections automatically means higher chances of Long-Covid purely by chance since you're expanding your timeframe of possibilities rather than anything else). On the other hand if someones cognitive symptoms with ME/CFS don't worsen, there's a lower chance they will be counted in the LC group. None of this would necessarily have much to do with Covid or Long-Covid (think for example that 50% of ME/CFS patients cognitive symptoms might worsen over a given timeframe, whilst for others it wouldn't, but you're setup would somewhat arbitrarily label them to distinct groups).

I'm by no means denying that things might not be as said or that Long-Covid doesn't cause cognitive problems or that cognitive problems might not worsen in ME/CFS following a Covid infection, but to know whether the results are interesting all depends on how rigorously these groups were looked at as part of the study.
 
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