Steven Lamontagne | Queen’s University in Kingston, Ontario
Lamontagne, S. J., Winters, M. F., Pizzagalli, D. A., & Olmstead, M. C. (2021). Post-acute sequelae of COVID-19: Evidence of mood & cognitive impairment. Brain, Behavior, & Immunity-Health, 17, 100347.
Long COVID: A Canadian study shows COVID-19 produces long-term detriments to mental health
The devastating health consequences of acute COVID-19 infection have been thoroughly characterized, but there is growing concern that those who survive the infection may experience long-term effects. Indeed, many survivors develop chronic and debilitating symptoms long after viral recovery, despite mild illness severity at onset, pointing to residual effects that span multiple organ systems within the nervous system. A study led by PhD student Steven Lamontagne is among the most widely cited long COVID articles since 2020 and reports that prior COVID-19 infection produces long-term detriments to mental health in individuals without prior (pre infection) mental health disturbances.
Specifically, the researchers found deficits in mood, reward responsiveness, and executive functioning that persisted for months following infection. With respect to task-based cognitive impairments, they found domain-specific deficits in cognitive control (i.e., executive functioning), but attentional alerting and orienting abilities remained intact. This suggests that COVID-19 specifically impacts higher-order executive functioning rather than widespread cognitive abilities.
Critically, these results were not a consequence of pre-pandemic mood or cognitive issues, given that all participants were carefully screened (in the control and past-COVID-19 groups) for lifetime history of any mental or physical health disorders. Unlike other studies investigating long COVID-19, this study (1) included a non-COVID-19 control group, (2) included a moderation analysis that revealed effects were not secondary to pandemic-related stress, and (3) only recruited COVID-19 survivors who were diagnosed at least 2 weeks prior to completing the study, reducing the likelihood of confounding effects related to acute infection (e.g., fever, nausea, headache). Of particular interest, these effects were not related to the age of participants or the severity of acute infection, suggesting that post-acute mental health sequelae might emerge regardless of illness severity or susceptibility.
This open-access article will be of particular importance as COVID-19 cases continue to rise globally. These findings point to potential protracted immune responses that contribute to persistent “sickness behaviours”, which are characteristic of hyperinflammatory reactions. Thus, this article could be a catalyst for future immunological studies to investigate therapies that temper the immune response in people with long COVID. This study was the first to examine reward-related deficits in COVID-19 survivors, as well as one of few to administer a well-validated computer-based task of attention (rather than a battery or self-reports).
These findings will not only help to develop treatments for long COVID-19 but may also encourage people to continue to adhere to public health measures to avoid infection.
Steven Lamontagne performed this study as a PhD student in the laboratory of Dr. Mary Olmstead at Queen’s University. As the principal investigator of the protocol, Steven Lamontagne designed the study and supervised data collection. He administered the tasks, analysed the data, and wrote the manuscript in its entirety with feedback and guidance from his supervisors. He is corresponding author on the manuscript.
Source of funding
This work was supported by a Discovery Grant from the Natural Sciences and Engineering Research Council (NSERC) of Canada to Dr. Olmstead and by an NSERC Alexander Graham Bell Graduate Scholarship to Dr. Lamontagne.