背景：全球新冠肺炎疫情大流行已持續多年，許多病人康復後可能出現長新冠症狀，其中認知功能障礙或稱腦霧（如注意力不集中、記憶力缺失、思維模糊等）對日常生活、心理健康及社會經濟產生廣泛影響，若未及早發現可能導致不可逆的認知損傷，增加醫療負擔與社會挑戰。
目的：旨在調查台灣新冠肺炎康復病人的認知功能狀況，並探討與長新冠相關的認知功能影響因素。
方法：本研究為橫斷式相關性研究，招募132名台灣感染新冠肺炎12週至2年內的成人受試者，排除有腦損傷病史、癌症病人、自身免疫疾病者、精神疾病和藥物濫用史，於醫院及社區進行收案。資料收集包含基本人口學特徵、過去病史，使用台灣版「蒙特利爾認知評估（MoCA）」量表評估新冠肺炎康復病人的認知功能，並利用SPSS軟體進行描述性統計、多變量共變異數分析、皮爾遜積差相關、多元回歸進行統計，分析認知功能狀況及其影響相關因素。
結果：多數新冠肺炎康復病人的MoCA得分大於26分，屬於正常範圍，但確診次數與延遲記憶、疫苗接種次數與專注力及住院史與多構面表現均呈顯著差異；多元回歸進一步指出，有住院者認知功能表現越差，而確診次數越多則認知功能表現越佳。
結論：住院史可能為新冠肺炎康復病人認知功能下降的風險指標。疫苗接種可能具保護作用，惟仍需更多研究支持。建議對曾住院者進行後續認知追蹤，並擴大樣本與採縱貫式設計以強化後續研究。

The COVID-19 pandemic has left many recovered individuals experiencing long-term cognitive impairments, commonly referred to as brain fog, which adversely affect daily functioning and quality of life. This study aimed to examine the cognitive function of COVID-19 recovered patients in southern Taiwan and identify related influencing factors. A cross-sectional correlational design was employed, recruiting 132 adults who had recovered from COVID-19 within 12 weeks to two years. Participants with neurological, psychiatric, or severe medical conditions were excluded. Data were collected through demographic and clinical questionnaires and assessed using the Taiwanese version of the Montreal Cognitive Assessment (MoCA). Statistical analyses, including descriptive statistics, MANCOVA, Pearson’s correlation, and multiple regression, were conducted using SPSS. Results showed that most participants scored above the MoCA cutoff of 26, indicating normal cognitive function. However, significant differences were observed between infection frequency and delayed memory, vaccination doses and attention, and hospitalization history and multiple cognitive domains. Regression analysis indicated that hospitalization predicted poorer cognitive outcomes, while a higher number of infections correlated with better performance. Hospitalization may serve as a risk indicator for post-COVID cognitive decline, whereas vaccination could have a protective role. Longitudinal studies with larger samples are recommended to validate these findings.

台灣認知功能促進協會（無日期）．認知功能障礙．取自於8月15日2023年，https://www.tcea-taiwan.com/TCEA/%e8%aa%8d%e7%9f%a5%e5%8a%9f%e8%83%bd%e9%9a%9c%e7%a4%99/
陳佳微（2013）．比較中文版之RUDAS、MMSE及MoCA於篩檢輕度認知障礙或失智症病人之敏感性、特異性分析：臺北醫學大學護理學研究所。
彭梓翔（2024）．初探認知功能障礙者感染新冠肺炎後的神經認知與精神症狀改變：中原大學心理學系研究所。
衛生福利部疾病管制署（無日期）．全國嚴重特殊傳染性肺炎本土病例及境外移入病例趨勢圖．傳染病統計資料查詢系統．取自於2月20日2025 年， https://nidss.cdc.gov.tw/nndss/disease?id=19CVS
Ahmad, S. J., Feigen, C. M., Vazquez, J. P., Kobets, A. J., & Altschul, D. J. (2022). Neurological sequelae of COVID-19. Journal of Integrative Neuroscience, 21(3), 77. https://doi.org/10.31083/j.jin2103077
Amalakanti, S., Arepalli, K. V. R., & Jillella, J. P. (2021). Cognitive assessment in asymptomatic COVID-19 subjects. Virusdisease, 32(1), 146-149. https://doi.org/10.1007/s13337-021-00663-w
Asadi-Pooya, A. A., Akbari, A., Emami, A., Lotfi, M., Rostamihosseinkhani, M., Nemati, H., Barzegar, Z., Kabiri, M., Zeraatpisheh, Z., Farjoud-Kouhanjani, M., Jafari, A., Sasannia, S., Ashrafi, S., Nazeri, M., Nasiri, S., & Shahisavandi, M. (2022). Long COVID syndrome-associated brain fog. Journal of Medical Virology, 94(3), 979-984. https://doi.org/10.1002/jmv.27404
Azzolini, E., Levi, R., Sarti, R., Pozzi, C., Mollura, M., Mantovani, A., & Rescigno, M. (2022). Association between BNT162b2 vaccination and long COVID after infections not requiring hospitalization in health care workers. The Journal of the American Medical Association, 328(7), 676-678. https://doi.org/10.1001/jama.2022.11691
Becker, J. H., Lin, J. J., Doernberg, M., Stone, K., Navis, A., Festa, J. R., & Wisnivesky, J.P. (2021). Assessment of cognitive function in patients after COVID-19 infection. JAMA Network Open, 4(10), e2130645. https://doi.org/10.1001/jamanetworkopen.2021.30645
Biagianti, B., Di Liberto, A., Nicolò Edoardo, A., Lisi, I., Nobilia, L., de Ferrabonc, G. D.,Zanier, E. R., Stocchetti, N., & Brambilla, P. (2022). Cognitive assessment in SARS-CoV-2 patients: A systematic review. Frontiers in Aging Neuroscience, 14, 909661. https://doi.org/10.3389/fnagi.2022.909661
Bowe, B., Xie, Y. & Al-Aly, Z. (2022). Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nature Medicine, 28, 2398-2405. https://doi.org/10.1038/s41591-022-02051-3
Callan, C., Ladds, E., Husain, L., Pattinson, K., & Greenhalgh, T. (2022). 'I can't cope withmultiple inputs': A qualitative study of the lived experience of 'brain fog' after COVID-19. The British Medical Journal Open, 12(2), e056366. https://doi.org/10.1136/bmjopen-2021-056366
Ceban, F., Ling, S., Lui, L. M. W., Lee, Y., Gill, H., Teopiz, K. M., Rodrigues, N. B., Subramaniapillai, M., Di Vincenzo, J. D., Cao, B., Lin, K., Mansur, R. B., Ho, R. C., Rosenblat, J. D., Miskowiak, K. W., Vinberg, M., Maletic, V., & McIntyre, R. S. (2022). Fatigue and cognitive impairment in post-COVID-19 syndrome: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 101, 93-135. https://doi.org/10.1016/j.bbi.2021.12.020
Ceban, F., Kulzhabayeva, D., Rodrigues, N. B., Di Vincenzo, J. D., Gill, H., Subramaniapillai, M., Lui, L. M. W., Cao, B., Mansur, R. B., Ho, R. C., Burke, M. J., Rhee, T. G., Rosenblat, J. D., & McIntyre, R. S. (2023). COVID-19 vaccination for the prevention and treatment of long COVID: A systematic review and meta-analysis. Brain, Behavior, and Immunity, 111, 211-229. https://doi.org/10.1016/j.bbi.2023.03.022
Centers for Disease Control and Prevention (CDC). (2024, June 14). COVID-19: Clinical care information and presentation. Centers for Disease Control and Prevention. https://www.cdc.gov/covid/hcp/clinical-care/covid19-presentation.html
Chasco, E. E., Dukes, K., Jones, D., Comellas, A. P., Hoffman, R. M., & Garg, A. (2022).Brain fog and fatigue following COVID-19 infection: An exploratory study of patient experiences of long COVID. International Journal of Environmental Research and Public Health, 19(23). https://doi.org/10.3390/ijerph192315499
COVID-19 Mental Disorders Collaborators (2021). Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet (London, England), 398(10312), 1700-1712. https://doi.org/10.1016/S0140-6736(21)02143-7
Cristillo, V., Pilotto, A., Piccinelli, S. C., Gipponi, S., Leonardi, M., Bezzi, M., & Padovani, A. (2022). Predictors of "brain fog" 1 year after COVID-19 disease. Neurological Sciences, 43(10), 5795-5797. https://doi.org/10.1007/s10072-022-06285-4
Crook, H., Raza, S., Nowell, J., Young, M., & Edison, P. (2021). Long covid-mechanisms, risk factors, and management. The British Medical Journal, 374, n1648. https://doi.org/10.1136/bmj.n1648
Fan, Y., Li, X., Zhang, L., Wan, S., Zhang, L., & Zhou, F. (2022). SARS-CoV-2 Omicron variant: Recent progress and future perspectives. Signal transduction and targeted therapy, 7(1), 141. https://doi.org/10.1038/s41392-022-00997-x
Foreman, L., Child, B., Saywell, I., Collins-Praino, L., & Baetu, I. (2025). Cognitive reserve moderates the effect of COVID-19 on cognition: A systematic review and meta-analysis of individual participant data. Neuroscience and Biobehavioral Reviews, 171, 106067. https://doi.org/https://doi.org/10.1016/j.neubiorev.2025.106067
Graham, E. L., Clark, J. R., Orban, Z. S., Lim, P. H., Szymanski, A. L., Taylor, C., DiBiase, R. M., Jia, D. T., Balabanov, R., Ho, S. U., Batra, A., Liotta, E. M., & Koralnik, I. J. (2021). Persistent neurologic symptoms and cognitive dysfunction in non- hospitalized covid-19 “long haulers”. Annals of Clinical and Translational Neurology, 8(5), 1073-1085. https://doi.org/https://doi.org/10.1002/acn3.51350
Green, S. B. (1991). How many subjects does it take to do a regression analysis? Multivariate Behavioral Research, 26(3), 499-510. https://doi.org/10.1207/s15327906mbr2603_7
Gualano, M. R., Rossi, M. F., Borrelli, I., Santoro, P. E., Amantea, C., Daniele, A., Tumminello, A., & Moscato, U. (2022). Returning to work and the impact of post COVID-19 condition: A systematic review. Work, 73(2), 405-413. https://doi.org/10.3233/wor-220103
Hampshire, A., Trender, W., Chamberlain, S. R., Jolly, A. E., Grant, J. E., Patrick, F., Mazibuko, N., Williams, S. C. R., Barnby, J. M., Hellyer, P., & Mehta, M. A. (2021). Cognitive deficits in people who have recovered from COVID-19. EClinicalMedicine, 39, 101044. https://doi.org/https://doi.org/10.1016/j.eclinm.2021.101044
Hampshire, A., Azor, A., Atchison, C., Trender, W., Hellyer, P. J., Giunchiglia, V., Husain, M., Cooke, G. S., Cooper, E., Lound, A., Donnelly, C. A., Chadeau-Hyam, M., Ward, H., & Elliott, P. (2024). Cognition and memory after covid-19 in a large community sample. The New England journal of medicine, 390(9), 806-818. https://doi.org/10.1056/NEJMoa2311330
Harrison, P. J., & Taquet, M. (2023). Neuropsychiatric disorders following SARS-CoV-2 infection. Brain, 146(6), 2241-2247. https://doi.org/10.1093/brain/awad008
Helms, J., Kremer, S., Merdji, H., Clere-Jehl, R., Schenck, M., Kummerlen, C., Collange, O., Boulay, C., Fafi-Kremer, S., Ohana, M., Anheim, M., & Meziani, F. (2020). Neurologic features in severe SARS-CoV-2 infection. New England Journal of Medicine, 382(23), 2268-2270. https://doi.org/10.1056/NEJMc2008597
Hugon, J., Msika, E. F., Queneau, M., Farid, K., & Paquet, C. (2022). Long COVID: Cognitive complaints (brain fog) and dysfunction of the cingulate cortex. Journal of Neurology, 269(1), 44-46. https://doi.org/10.1007/s00415-021-10655-x
Invernizzi, A., Renzetti, S., van Thriel, C., Rechtman, E., Patrono, A., Ambrosi, C., Mascaro, L., Corbo, D., Cagna, G., Gasparotti, R., Reichenberg, A., Tang, C. Y., Lucchini, R. G., Wright, R. O., Placidi, D., & Horton, M. K. (2024). COVID-19 related cognitive, structural and functional brain changes among Italian adolescents and young adults: A multimodal longitudinal case-control study. Translational Psychiatry, 14(1), 402. https://doi.org/10.1038/s41398-024-03108-2
Kalim, H., Pratama, M. Z., Mahardini, E., Winoto, E. S., Krisna, P. A., & Handono, K. (2020). Accelerated immune aging was correlated with lupus-associated brain fog in reproductive-age systemic lupus erythematosus patients. International Journal of Rheumatic Diseases, 23(5), 620-626. https://doi.org/10.1111/1756-185x.13816
Kim, Y., Bae, S., Chang, H. H., & Kim, S. W. (2023). Long COVID prevalence and impact on quality of life 2 years after acute COVID-19. Scientific Reports, 13(1), 11207. https://doi.org/10.1038/s41598-023-36995-4
Krishnan, K., Lin, Y., Prewitt, K. M., & Potter, D. A. (2022). Multidisciplinary approach to brain fog and related persisting symptoms post COVID-19. Journal of Health Service Psychology, 48(1), 31-38. https://doi.org/10.1007/s42843-022-00056-7
Lippi, G., Sanchis-Gomar, F., & Henry, B. M. (2023). COVID-19 and its long-term sequelae: What do we know in 2023? Polish Archives of Internal Medicine, 133(4). https://doi.org/10.20452/pamw.16402
Liu, Y.-H., Chen, Y., Wang, Q.-H., Wang, L.-R., Jiang, L., Yang, Y., Chen, X., Li, Y., Cen, Y., Xu, C., Zhu, J., Li, W., Wang, Y.-R., Zhang, L.-L., Liu, J., Xu, Z.-Q., & Wang, Y.-J. (2022). One-year trajectory of cognitive changes in older survivors of COVID-19 in Wuhan, China: A longitudinal cohort study. JAMA Neurology, 79(5), 509-517. https://doi.org/10.1001/jamaneurol.2022.0461
Lynch, S., Ferrando, S. J., Dornbush, R., Shahar, S., Smiley, A., & Klepacz, L. (2022). Screening for brain fog: Is the montreal cognitive assessment an effective screening tool for neurocognitive complaints post-COVID-19? General Hospital Psychiatry, 78, 80-86. https://doi.org/10.1016/j.genhosppsych.2022.07.013
Maki, P. M., & Jaff, N. G. (2022). Brain fog in menopause: A health-care professional's guide for decision-making and counseling on cognition. Climacteric, 25(6), 570-578. https://doi.org/10.1080/13697137.2022.2122792
Mazza, M. G., De Lorenzo, R., Conte, C., Poletti, S., Vai, B., Bollettini, I., Melloni, E. M. T., Furlan, R., Ciceri, F., Rovere-Querini, P., & Benedetti, F. (2020). Anxiety and depression in COVID-19 survivors: Role of inflammatory and clinical predictors. Brain, Behavior, and Immunity, 89, 594-600. https://doi.org/https://doi.org/10.1016/j.bbi.2020.07.037
Mirfazeli, F. S., Sarabi-Jamab, A., Pereira-Sanchez, V., Kordi, A., Shariati, B., Shariat, S. V., Bahrami, S., Nohesara, S., Almasi-Dooghaee, M., & Faiz, S. H. R. (2022). Chronic fatigue syndrome and cognitive deficit are associated with acute-phase neuropsychiatric manifestations of COVID-19: A 9-month follow-up study. Neurological Sciences, 43(4), 2231-2239. https://doi.org/10.1007/s10072-021-05786-y
Miskowiak, K. W., Johnsen, S., Sattler, S. M., Nielsen, S., Kunalan, K., Rungby, J., Lapperre, T., & Porsberg, C. M. (2021). Cognitive impairments four months after COVID-19 hospital discharge: Pattern, severity and association with illness variables. European Neuropsychopharmacology, 46, 39-48. https://doi.org/10.1016/j.euroneuro.2021.03.019
Mizrahi, B., Sudry, T., Flaks-Manov, N., Yehezkelli, Y., Kalkstein, N., Akiva, P., Ekka-Zohar, A., Ben David, S. S., Lerner, U., Bivas-Benita, M., & Greenfeld, S. (2023). Long covid outcomes at one year after mild SARS-CoV-2 infection: Nationwide cohort study. The British Medical Journal, 380, e072529. https://doi.org/10.1136/bmj-2022-072529
Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., Cummings, J. L., & Chertkow, H. (2005). The montreal cognitive assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53(4), 695-699. https://doi.org/10.1111/j.1532-5415.2005.53221.x
National Institute for Health and Care Excellence (NICE). (2024, January 25). COVID-19 rapid guideline: Managing the long-term effects of COVID-19. https://www.nice.org.uk/guidance/ng188
Nehme, M., Braillard, O., Salamun, J., Jacquerioz, F., Courvoisier, D. S., Spechbach, H., & Guessous, I. (2022). Symptoms after COVID-19 vaccination in patients with post-acute sequelae of SARS-CoV-2. Journal of General Internal Medicine, 37(6), 1585-1588. https://doi.org/10.1007/s11606-022-07443-2
Nouraeinejad, A. (2023). Brain fog as a long-term sequela of COVID-19. SN Comprehensive Clinical Medicine, 5(1), 9. https://doi.org/10.1007/s42399-022-01352-5
Ocon, A. J. (2013). Caught in the thickness of brain fog: Exploring the cognitive symptoms of chronic fatigue syndrome. Frontiers in Physiology, 4, 63. https://doi.org/10.3389/fphys.2013.00063
Orfei, M. D., Porcari, D. E., D'Arcangelo, S., Maggi, F., Russignaga, D., & Ricciardi, E. (2022). A new look on long-COVID effects: The functional brain fog syndrome. Journal of Clinical Medicine, 11(19). https://doi.org/10.3390/jcm11195529
Orrù, G., Bertelloni, D., Diolaiuti, F., Mucci, F., Di Giuseppe, M., Biella, M., Gemignani, A., Ciacchini, R., & Conversano, C. (2021). Long-COVID syndrome? A study on the persistence of neurological, psychological and physiological symptoms. Healthcare(Basel), 9(5). https://doi.org/10.3390/healthcare9050575
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Kokmen, E., & Tangelos, E. G. (1997). Aging, memory, and mild cognitive impairment. International Psychogeriatrics, 9 Suppl 1, 65-69. https://doi.org/10.1017/s1041610297004717
Schou, T. M., Joca, S., Wegener, G., & Bay-Richter, C. (2021). Psychiatric and neuropsychiatric sequelae of COVID-19 - A systematic review. Brain, Behavior, and Immunity, 97, 328-348. https://doi.org/10.1016/j.bbi.2021.07.018
Taquet, M., Dercon, Q., & Harrison, P. J. (2022). Six-month sequelae of post-vaccination SARS-CoV-2 infection: A retrospective cohort study of 10,024 breakthrough infections. Brain, Behavior, and Immunity, 103, 154-162. https://doi.org/10.1016/j.bbi.2022.04.013
Taquet, M., Skorniewska, Z., De Deyn, T., Hampshire, A., Trender, W. R., Hellyer, P. J., Chalmers, J. D., Ho, L.-P., Horsley, A., Marks, M., Poinasamy, K., Raman, B., Leavy, O. C., Richardson, M., Elneima, O., McAuley, H. J. C., Shikotra, A., Singapuri, A., Sereno, M., . . . Turnbull, A. (2024). Cognitive and psychiatric symptom trajectories 2–3 years after hospital admission for COVID-19: A longitudinal, prospective cohort study in the UK. The Lancet Psychiatry, 11(9), 696-708. https://doi.org/10.1016/S2215-0366(24)00214-1
Theoharides, T. C., Cholevas, C., Polyzoidis, K., & Politis, A. (2021). Long-COVID syndrome-associated brain fog and chemofog: Luteolin to the rescue. Biofactors, 47(2), 232-241. https://doi.org/10.1002/biof.1726
Tsai, C. F., Lee, W. J., Wang, S. J., Shia, B. C., Nasreddine, Z., & Fuh, J. L. (2012). Psychometrics of the montreal cognitive assessment (MoCA) and its subscales: Validation of the Taiwanese version of the MoCA and an item response theory analysis. International Psychogeriatrics, 24(4), 651-658. https://doi.org/10.1017/s1041610211002298
Turana, Y., Nathaniel, M., Shen, R., Ali, S., & Aparasu, R. R. (2022). Citicoline and COVID-19-related cognitive and other neurologic complications. Brain Sciences, 12(1), 59. https://doi.org/10.3390/brainsci12010059
Vindegaard, N., & Benros, M. E. (2020). COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain, Behavior, and Immunity, 89, 531-542. https://doi.org/10.1016/j.bbi.2020.05.048
World Health Organization (WHO). (2021a, September 27). Support for rehabilitation: Self-management after COVID-19-related illness, second edition. https://iris.who.int/bitstream/handle/10665/344472/WHO-EURO-2021-855-40590-59892-eng.pdf?sequence=1
World Health Organization (WHO). (2021b, December 16). Coronavirus disease (COVID-19): Post COVID-19 condition. https://www.who.int/news-room/questions-and-answers/item/coronavirus-disease-(covid-19)-post-covid-19-condition
Yeung, S. P., Guo, P., Adlard, F. L., Zhang, S. R., Bhagat, V., Cho, J., Curtis, L., Kaser, M., Haggard, M. P., & Cheke, L. G. (2025). COVCOG 3—Trajectory of long COVID: Longitudinal changes in symptoms and cognitive impairment. Applied Cognitive Psychology, 39(2), e70040. https://doi.org/10.1002/acp.70040
Zhou, H., Lu, S., Chen, J., Wei, N., Wang, D., Lyu, H., Shi, C., & Hu, S. (2020). The landscape of cognitive function in recovered COVID-19 patients. Journal of Psychiatric Research, 129, 98-102. https://doi.org/10.1016/j.jpsychires.2020.06.022