Self‐rated PROMIS cognitive function is a better predictor of long COVID related functional impairment than the Montreal Cognitive Assessment
Bibliographic record
Abstract
BACKGROUND: Neurocognitive symptoms are among the most debilitating features of long COVID (persistent, ongoing symptoms and conditions following SARS-CoV-2 infection). Traditional neurocognitive screening instruments have been found to be non-sensitive to post-COVID cognitive impairments, often described as 'brain fog', that disrupt performance of complex daily routines. Accurate screening and diagnosis of cognitive impairment is therefore a critical area of clinical research for people with long COVID. We examined whether self-reported or neuropsychological cognitive function tests were more strongly associated with long COVID. METHODS: In a sample from a community-engaged cross-sectional cohort study, we fitted a binary logistic regression model for the outcome of long COVID status (having history of COVID illness, plus a Post-COVID Functional Status Scale (PCFS) score >=2), classified by MoCA cut score weighted for race/ethnicity, and associated with the Patient-Reported Outcomes Measurement Information System (PROMIS) 8-item Cognitive Functioning t-scores, controlling for age. RESULTS: We analyzed data from N = 174 participants (n = 67 cases, n = 107 controls). Our final model was fitted with 5-knot natural cubic splines for age and PROMIS Cognition scores. At a "Non-impaired" score on the MoCA, a PROMIS t-score at the lower quartile of 36.67 increased the odds of having long COVID by over seven times at age 25 (1.0,56.89, p = 0.01), over five times at ages 45 (1.4,18.6, p = 0.001) and 55 (1.4,20.4, p = 0.002), and six times at ages 65 (0.9,51.2, p = 0.02) and 75 (0.8,48.9, p = 0.03). By contrast, scores above and below race/ethnicity-weighted MoCA cut score did not significantly affect the odds of having long COVID at any age (p value ranges 0.22-0.25 and 0.19-0.22, respectively) adjusted for mean PROMIS score. CONCLUSION: Across ages, low PROMIS Cognitive Function scores showed between five- and six-fold increases in odds of long COVID, adjusted for age and MoCA score. This self-rated cognitive function scale was the best predictor of functional status changes attributed to post-COVID-19 health changes in our sample.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".