In addition to its well-known respiratory manifestations, COVID-19 can lead to neurological and cognitive disorders, especially in elderly patients. Since the severity of lung involvement may reflect the extent of hypoxia and systemic inflammation, examining its relationship with cognitive function holds significant clinical importance. This study aimed to investigate the association between the extent of pulmonary involvement and the occurrence of major neurocognitive disorders in patients over 60 years old with COVID-19.

Materials and Methods:

This retrospective cohort study was conducted on 1,194 patients over the age of 60 with COVID-19 at Kosar Hospital in Sanandaj during the years 2020 to 2023. Patient data were extracted from hospital records, and their cognitive function was assessed at least six months after recovery using the Mini-Mental State Examination (MMSE). Based on chest CT scan findings, patients were divided into two groups: those with less than 50% lung involvement and those with more than 50%. Data were analyzed using Stata 16 software and statistical tests including Chi-square, Mann-Whitney, and logistic regression. A significance level of p < 0.05 was considered.

Findings:

The average age of patients was 70.34±7.04 years, and 56.3% were male. The mean MMSE score across the sample was 27.66±4.54. Overall, 94.6% had normal cognitive function, while 5.4% showed varying degrees of cognitive impairment (1.3% mild, 0.5% moderate, 3.6% severe). MMSE scores were lower in patients with greater lung involvement, but this difference was not statistically significant (p=0.088). Additionally, no significant association was found between cognitive impairment and variables such as age, gender, education level, or underlying conditions (hypertension and diabetes).

Conclusion:

The results of this study indicate that although a percentage of elderly COVID-19 patients develop major neurocognitive disorders, the extent of lung involvement on CT scans is not a significant predictor of such disorders. Nevertheless, patients with more extensive lung involvement tended to have lower cognitive scores. This finding highlights the importance of regular cognitive screening in elderly patients recovering from COVID-19, even in cases of moderate disease severity, and underscores the need for cognitive rehabilitation programs and long-term follow-up.