The COVID-19 Related Cognitive Impairments Among Non- Hospitalized and Hospitalized Patients; A Comparative Study

Background: Different patterns and severity of neuropsychological symptoms are reported in patients with
COVID-19. The exact pathophysiologic mechanisms responsible for the neuropsychological manifestations of
COVID-19 remain unknown. This study aimed to compare the cognitive impairments between hospitalized and
non-hospitalized patients with COVID-19.
Methods: This cross-sectional study was performed in a referral hospital in Iran from March 2020 to March 2021. Neuropsychiatric assessments were conducted using the Addenbrooke’s Cognitive Examination (ACE) test. Demographic factors, medical history, hospitalization duration, and ACE scores were assessed. Statistical analysis was performed using SPSS.
Results: In this study, 219 patients with COVID-19 (114 hospitalized and 105 non-hospitalized) were evaluated.
The mean age of hospitalized patients was significantly higher than that of outpatient participants (48.46 vs.
34.32 years; P < 0.001). Gender, handedness, education level, and habitual history did not differ significantly
between the two groups. Dexamethasone administration was significantly more common in hospitalized patients.
The total and subgroup ACE scores in hospitalized patients were significantly lower than those in the outpatient
group. Cognitive impairments were detected significantly more frequently in hospitalized patients. Multivariate
analysis showed that cognitive impairments were significantly more common among hospitalized patients (P <
0.001).
Conclusions: The cognitive ability of hospitalized patients with COVID-19 is lower than that of their outpatient
counterparts regarding executive function, verbal fluency, memory, language, and visual perception. Hospitalized patients with COVID-19 should undergo more detailed neuropsychological evaluations and receive appropriate treatments accordingly.

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Issue	Vol 9 No 1 (2026)
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Keywords
COVID-19 Cognitive Impairments Hospitalization Outpatients Neuropsychiatric test

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Ebrahimi H, Ebrahimi MJ, Moaveni AK, Moafi M, Pour-Rashidi A, Hadadi A, Montazeri M, Pakozi M, Kafan S, Nasseri S, Gholami Z, Aghayerashti M, Kianimehr G, Amirjamshidi A. The COVID-19 Related Cognitive Impairments Among Non- Hospitalized and Hospitalized Patients; A Comparative Study. AJS. 2026;9(1):6-11.

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