Neurocognitive sequelae following COVID-19 infection in older adults with and without pre-infection neurocognitive impairment

In this case report,we describe the clinical characteristics of three older adults aged >65years with cognitive difficulties prior to theirCOVID-19 infection who reported worsening of neurocognitive symptoms in the convalescent COVID-19 phase. Formal neuropsychological testingalong with neuroimaging were included with each patient. These patients described an initial worseningin cognitive functionafter recovering from the acute phase of COVID19. This case reportdescribes variable recoveryof cognitive abilities in the convalescent stage. The direct effectof the viral infection itselfon cognitive function are well documented. We hypothesize that the persistent inflammatory or immune response in the convalescent COVID-19 stage, more commonly referred to as the indirect mechanism, contributes to the clinical syndromeknown as the Post-Acute Sequelae of SARS-CoV-2 (PASC).