Post-COVID cognitive deficits are clinically complex with both objective and subjective components. They are common, debilitating, and can affect ability to work. Yet their biological underpinning remains unknown. In this prospective cohort study of 1837 individuals hospitalised with COVID-19, we identified two distinct biomarker profiles measured during the acute admission which predict cognitive outcomes 6 and 12 months post-COVID-19. A first profile links elevated fibrinogen relative to CRP with both objective and subjective cognitive deficits. A second profile links elevated D-dimer relative to CRP with subjective but not objective cognitive deficits, and with occupational impact at 6 and 12 months. Fatigue and shortness of breath were mediators of this second profile. Results were robust across secondary analyses. They were replicated and their specificity to COVID-19 were tested in a large-scale electronic health records dataset. These findings provide insights into the heterogeneous biology of post-COVID ‘brain fog’.
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Taquet, M., Skorniewska, Z., Hampshire, A., Chalmers, J., Ho, L., Horsley, A., Marks, M., Poinasamy, K., Raman, B., Leavy, O., Richardson, M., Elneima, O., McAuley, H., Shikotra, A., Singapuri, A., Sereno, M., Saunders, R., Harris, V., Houchen-Wolloff, L., Greening, N., Mansoori, P., Harrison, E., Docherty, A., Lone, N. & PHOSP-COVID Study Collaborative Group 2023, 'Acute blood biomarker profiles predict cognitive deficits 6 and 12 months after COVID-19 hospitalization', Nature Medicine. https://doi.org/10.1038/s41591-023-02525-y