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Peer-reviewedCC BY 4.0Nutrients

Dietary Vitamin Intake and Cognitive Performance in Adults with Long COVID: The BioICOPER Study

  • David Arjol1,2,3
  • Silvia Arroyo-Romero1,2,3,4
  • David Rodriguez García1,2,3,4
  • Elena Navarro-Matías1,2,3,4,5
  • Alicia Navarro-Cáceres1,2,3,4
  • Nuria Suárez-Moreno1,2,3,4
  • Andrea Domínguez-Martín1,2,3,4
  • Manuel A. Gómez-Marcos1,2,3,4,5
  • Marta Gómez-Sánchez6
  • Leticia Gómez-Sánchez7
  • BioICOPER Investigators Group
7 affiliations
  1. 1Unidad de Investigación de Atención Primaria de Salamanca (APISAL), Avd. Portugal, 37005 Salamanca, Spain
  2. 2Instituto de Investigación Biomédica de Salamanca (IBSAL), Paseo de San Vicente, 37007 Salamanca, Spain
  3. 3Red de Investigación Sobre Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), 37005 Salamanca, Spain
  4. 4Servicio de Salud de Castilla y León-SACYL, Gestión Regional de Salud, 37005 Salamanca, Spain
  5. 5Departamento de Medicina, Facultad de Medicina, Universidad de Salamanca, Calle Alfonso X El Sabio s/n, 37007 Salamanca, Spain
  6. 6Servicio de Hospitalización Domiciliaria, Hospital Universitario Marqués de Valdecilla, 39008 Santander, Spain
  7. 7Servicio de Urgencias, Hospital Universitario de La Paz, P. de Castellana, 261, 28046 Madrid, Spain
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Abstract

Background: Long COVID (LC) is associated with persistent cognitive symptoms, frequently described as brain fog, and with inflammatory, immunometabolic, and energetic mechanisms potentially involved in cognitive functioning. Vitamins participate in biological processes relevant to brain function, but the relationship between habitual dietary vitamin intake and cognitive performance in LC remains poorly studied. Objective: To analyze the relationship between dietary vitamin intake and cognitive performance in adults with LC, considering both objective performance and self-reported cognition. Methods: A cross-sectional study was conducted in 304 adults with LC. Vitamin intake from foods and beverages was estimated using the EVIDENT seven-day dietary record, previously compared with a validated food-frequency questionnaire. Objective cognitive performance was assessed using normative scores from the Montreal Cognitive Assessment (MoCA) and the Memory Index Score (MIS), as well as MoCA domains and items. Self-reported cognition was assessed using the 30-item Memory Failures of Everyday Questionnaire (MFE-30) and the cognitive subscale of the Modified Fatigue Impact Scale (MFIS). Primary global associations were examined using multiple linear regression with HC3 robust standard errors, whereas bounded MoCA domains were analyzed using proportional-odds ordinal regression and binary item-level outcomes using logistic regression. Benjamini–Hochberg correction was applied within prespecified families of contrasts. Results: No associations between vitamin intake and global normative cognitive performance remained significant after false discovery rate (FDR) correction. Median MoCA and MIS scores were 24.00 (IQR, 21.00–26.00) and 11.00 (IQR, 9.00–13.00), respectively. Normative MoCA and MIS scores showed medians of −0.32 (IQR, −0.82 to 0.19) and −0.32 (IQR, −0.76 to 0.14), respectively. Most participants (95.1%) met the dietary reference value for vitamin B3. In secondary ordinal analyses, higher vitamin B3 intake was associated with better MoCA language performance in the fully adjusted model (OR per 1 SD = 2.18, 95% CI 1.45–3.27, p < 0.001, q = 0.0116). No associations remained significant after FDR correction for everyday cognitive complaints, cognitive fatigue, or MoCA Memory and MoCA Multiple scores. Conclusions: In adults with LC, the primary analyses did not identify FDR-significant associations between habitual dietary vitamin intake and global normative cognitive performance. The secondary vitamin B3–language association requires independent confirmation and does not establish a cognitive benefit of higher intake or supplementation. These findings require confirmation in longitudinal studies incorporating nutritional biomarkers, information on supplementation, and broader neuropsychological assessment.

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Cite

BibTeXRIS
BibTeX
@article{arjol2026dietary,
  title = {{Dietary Vitamin Intake and Cognitive Performance in Adults with Long COVID: The BioICOPER Study}},
  author = {David Arjol and Silvia Arroyo-Romero and David Rodriguez García and Elena Navarro-Matías and Alicia Navarro-Cáceres and Nuria Suárez-Moreno and Andrea Domínguez-Martín and Manuel A. Gómez-Marcos and Marta Gómez-Sánchez and Leticia Gómez-Sánchez and BioICOPER Investigators Group},
  journal = {Nutrients},
  year = {2026},
  month = oct,
  doi = {10.3390/nu18203370},
  url = {https://www.mdpi.com/2072-6643/18/20/3370},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Dietary Vitamin Intake and Cognitive Performance in Adults with Long COVID: The BioICOPER Study
AU  - David Arjol
AU  - Silvia Arroyo-Romero
AU  - David Rodriguez García
AU  - Elena Navarro-Matías
AU  - Alicia Navarro-Cáceres
AU  - Nuria Suárez-Moreno
AU  - Andrea Domínguez-Martín
AU  - Manuel A. Gómez-Marcos
AU  - Marta Gómez-Sánchez
AU  - Leticia Gómez-Sánchez
AU  - BioICOPER Investigators Group
PY  - 2026
DA  - 2026/10/01
JO  - Nutrients
DO  - 10.3390/nu18203370
UR  - https://www.mdpi.com/2072-6643/18/20/3370
AB  - Background: Long COVID (LC) is associated with persistent cognitive symptoms, frequently described as brain fog, and with inflammatory, immunometabolic, and energetic mechanisms potentially involved in cognitive functioning. Vitamins participate in biological processes relevant to brain function, but the relationship between habitual dietary vitamin intake and cognitive performance in LC remains poorly studied. Objective: To analyze the relationship between dietary vitamin intake and cognitive performance in adults with LC, considering both objective performance and self-reported cognition. Methods: A cross-sectional study was conducted in 304 adults with LC. Vitamin intake from foods and beverages was estimated using the EVIDENT seven-day dietary record, previously compared with a validated food-frequency questionnaire. Objective cognitive performance was assessed using normative scores from the Montreal Cognitive Assessment (MoCA) and the Memory Index Score (MIS), as well as MoCA domains and items. Self-reported cognition was assessed using the 30-item Memory Failures of Everyday Questionnaire (MFE-30) and the cognitive subscale of the Modified Fatigue Impact Scale (MFIS). Primary global associations were examined using multiple linear regression with HC3 robust standard errors, whereas bounded MoCA domains were analyzed using proportional-odds ordinal regression and binary item-level outcomes using logistic regression. Benjamini–Hochberg correction was applied within prespecified families of contrasts. Results: No associations between vitamin intake and global normative cognitive performance remained significant after false discovery rate (FDR) correction. Median MoCA and MIS scores were 24.00 (IQR, 21.00–26.00) and 11.00 (IQR, 9.00–13.00), respectively. Normative MoCA and MIS scores showed medians of −0.32 (IQR, −0.82 to 0.19) and −0.32 (IQR, −0.76 to 0.14), respectively. Most participants (95.1%) met the dietary reference value for vitamin B3. In secondary ordinal analyses, higher vitamin B3 intake was associated with better MoCA language performance in the fully adjusted model (OR per 1 SD = 2.18, 95% CI 1.45–3.27, p < 0.001, q = 0.0116). No associations remained significant after FDR correction for everyday cognitive complaints, cognitive fatigue, or MoCA Memory and MoCA Multiple scores. Conclusions: In adults with LC, the primary analyses did not identify FDR-significant associations between habitual dietary vitamin intake and global normative cognitive performance. The secondary vitamin B3–language association requires independent confirmation and does not establish a cognitive benefit of higher intake or supplementation. These findings require confirmation in longitudinal studies incorporating nutritional biomarkers, information on supplementation, and broader neuropsychological assessment.
SN  - 2072-6643
ER  -