A recent study conducted by experts from the Johns Hopkins University School of Medicine has found that patients living with HIV may experience worsened cognitive function during the first four months after being infected with SARS-CoV-2. However, the study suggests that these differences in cognitive function are likely attributable to HIV rather than COVID-19. The study involved a mostly vaccinated group of patients, and it also revealed that processing speed may be impaired in vaccinated patients without HIV in the months following COVID-19.
Both long COVID and HIV are associated with neurocognitive dysfunction, with symptoms such as brain fog, memory issues, and difficulties with concentration frequently reported after COVID-19 in the general population. HIV, on the other hand, is known to affect brain function, leading to problems with memory, decision-making, attention, and concentration. However, it is not yet clear whether individuals with and without HIV experience different neurocognitive symptoms or outcomes following COVID-19.
The new study involved 294 adults living in the lower 48 states who were enrolled in the Foundation for AIDS Research-Johns Hopkins University COVID Recovery Study. Researchers explored whether patients living with HIV were more likely to experience neurocognitive symptoms post-COVID-19, as suggested by a previous study. The researchers also investigated whether there were any differences in cognitive function between those with and without HIV who believed they had never been infected with COVID-19.
Since HIV-Associated Neurocognitive Disorder (HAND) affects up to 50% of individuals living with HIV, the researchers simultaneously assessed this population to determine whether differences in cognitive function measured by neurologic testing were associated with HIV or COVID-19.
Results indicated that COVID-19 survivors with HIV had lower scores in crystallized cognition, verbal memory, and fluency than those without HIV, one month post-COVID-19, after adjusting for age, sex, education, and body mass index. The crystallized cognition test was also adjusted for COVID-19 vaccination, and verbal fluency tests were further adjusted for race, income, and recreational drug use. Verbal memory and category-cued verbal fluency differences remained for four months post-COVID-19. However, no significant differences were found in cognitive assessments between HIV-positive individuals with and without COVID-19 at one month post-infection or enrollment, respectively. Hence, HIV was inferred to be the reason for cognition differences, rather than COVID-19.
Our research is the first to suggest that post-COVID differences in cognition between people living with HIV and without HIV are likely more so due to HIV rather than COVID-19. The cognitive changes we observed that were attributable to COVID-19 were in our HIV-negative participants. Processing speed was decreased at 1 and 4 months post-COVID in people without HIV.
Alisha Dziarski, MD, John Hopkins School of School of Medicine, Baltimore, USA.