Psychological burden, subjective complaints and their impact on the progression of verbal fluency in COVID-19 survivors and healthy controls: a longitudinal analysis
6 affiliations
- 1Department of Psychology, University of Bamberg, Bamberg, Germany
- 2German Center for Neurodegenerative Diseases, Bonn, Germany
- 3Department of Neurology, University of Bonn Medical Center, Bonn, Germany
- 4Luxembourg Centre for Systems Biomedicine (LCSB), Department of Infectious Diseases and Immunology, University of Luxembourg, University of Massachusetts Medical School Worcester, MA Worcester, USA
- 5Institute of Innate Immunity, University of Bonn, Bonn, Germany
- 6Department of Neuroimmunology, Department of Parkinson’s Disease, Sleep and Movement Disorders, Center for Neurology, German Center for Neurodegenerative Diseases, University of Bonn Medical Center, Bonn, Germany
Abstract
Background: This study aimed to investigate the longitudinal change of verbal fluency after COVID-19 and potential influencing factors in a community-based sample. Within the COVIMMUNE-Clin study at the University of Bonn Medical Center, participants with a mild course of COVID-19 (n = 52), a severe course (n = 52), and healthy controls (n = 55) were compared. This focused secondary analysis examined verbal fluency as a distinct cognitive outcome within the broader study.
Methods: Semantic and lexical verbal fluency, assessed using the Vienna Verbal Fluency Test (WIWO), as well as psychological burden measured by the ICD-10 Symptom Rating Scale (ISR) and subjective complaints assessed with the Everyday Cognition-12 (ECog-12) questionnaire, were administered at the first visit and again after 12 months. A linear mixed model was employed, incorporating Group (mild, severe and healthy controls) and Visit as fixed effects, with Subject and the Intercept as random effects. ISR and ECog-12 were each incorporated into separate models as fixed effects.
Results: Group and psychological burden had an impact on semantic fluency, in a way that more severe disease and higher psychological burden were associated with lower performance. Contrary to the hypothesis, verbal fluency did not significantly change over 12 months. Across models, verbal fluency types showed distinctive patterns, which is reflected by the fact that psychological burden and subjective complaints only showed an association with semantic fluency performance. Lexical fluency showed no significant effects of these constructs and was primarily positively influenced by education.
Conclusion: COVID-19 disease severity, psychological burden, and subjective complaints were associated with semantic fluency. These findings support further research on whether verbal fluency measures, in combination with self-reported symptoms, may contribute to practical assessment approaches following COVID-19.
Trial registration: Specific details of the study design are included at the German Clinical Trials Registry (primary registry trial identifier: DRKS00023806; registration date: March 16, 2021, cross-referenced at World Health Organization’s International Clinical Trials Registry Platform [ICTRP]).
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s40359-026-05929-w.
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BibTeX
@article{kauffmann2026psychological,
title = {{Psychological burden, subjective complaints and their impact on the progression of verbal fluency in COVID-19 survivors and healthy controls: a longitudinal analysis}},
author = {Vanessa Kauffmann and Susan Seibert and Michael Heneka and Jascha Rüsseler and Catherine N. Widmann},
journal = {BMC Psychology},
year = {2026},
month = nov,
doi = {10.1186/s40359-026-05929-w},
url = {https://doi.org/10.1186/s40359-026-05929-w},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Psychological burden, subjective complaints and their impact on the progression of verbal fluency in COVID-19 survivors and healthy controls: a longitudinal analysis
AU - Vanessa Kauffmann
AU - Susan Seibert
AU - Michael Heneka
AU - Jascha Rüsseler
AU - Catherine N. Widmann
PY - 2026
DA - 2026/11/04
JO - BMC Psychology
DO - 10.1186/s40359-026-05929-w
UR - https://doi.org/10.1186/s40359-026-05929-w
AB - Background: This study aimed to investigate the longitudinal change of verbal fluency after COVID-19 and potential influencing factors in a community-based sample. Within the COVIMMUNE-Clin study at the University of Bonn Medical Center, participants with a mild course of COVID-19 (n = 52), a severe course (n = 52), and healthy controls (n = 55) were compared. This focused secondary analysis examined verbal fluency as a distinct cognitive outcome within the broader study. Methods: Semantic and lexical verbal fluency, assessed using the Vienna Verbal Fluency Test (WIWO), as well as psychological burden measured by the ICD-10 Symptom Rating Scale (ISR) and subjective complaints assessed with the Everyday Cognition-12 (ECog-12) questionnaire, were administered at the first visit and again after 12 months. A linear mixed model was employed, incorporating Group (mild, severe and healthy controls) and Visit as fixed effects, with Subject and the Intercept as random effects. ISR and ECog-12 were each incorporated into separate models as fixed effects. Results: Group and psychological burden had an impact on semantic fluency, in a way that more severe disease and higher psychological burden were associated with lower performance. Contrary to the hypothesis, verbal fluency did not significantly change over 12 months. Across models, verbal fluency types showed distinctive patterns, which is reflected by the fact that psychological burden and subjective complaints only showed an association with semantic fluency performance. Lexical fluency showed no significant effects of these constructs and was primarily positively influenced by education. Conclusion: COVID-19 disease severity, psychological burden, and subjective complaints were associated with semantic fluency. These findings support further research on whether verbal fluency measures, in combination with self-reported symptoms, may contribute to practical assessment approaches following COVID-19. Trial registration: Specific details of the study design are included at the German Clinical Trials Registry (primary registry trial identifier: DRKS00023806; registration date: March 16, 2021, cross-referenced at World Health Organization’s International Clinical Trials Registry Platform [ICTRP]). Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s40359-026-05929-w.
SN - 2050-7283
ER -