Evaluation of Cognitive Functions in People Living with HIV Before and After COVID-19 Infection.

Background: Cognitive function decline is a problem in aging people living with HIV (PLWHIV). COVID-19 infection is associated with neuropsychiatric manifestations that may persist. The aim of our study was to evaluate cognitive function in PLWHIV before and after COVID-19 infection.

Methods: This was a prospective observational study conducted at "Laiko" General Hospital from July 2019 to July 2024. The Montreal Cognitive Assessment (MOCA) scale was used to evaluate cognitive functions.

Results: 116 virally suppressed PLWHIV participated (mean age: 47.6 years, 91.4% male); 60 underwent repeated evaluation after the pandemic at a median interval of 3.1 years. The median MOCA score was 24 (22-26), with 35.3% scoring within normal limits. A negative correlation was observed between MOCA scores and age (ρ = -0.283, = 0.002), but not with a CD4 count at diagnosis (ρ = 0.169, = 0.071) or initial HIV RNA load (ρ = 0.02, = 0.984). In the subgroup with repeated testing, MOCA was correlated with the CD4 count (ρ = 0.238, = 0.069 in the first and ρ = 0.319, = 0.014 second test). An improvement in performance was observed (median score increase from 24 to 25, = 0.02).

Conclusions: MOCA can detect early changes in cognitive function in PLWHIV. Further studies are required to determine the role of COVID-19 over time.