In 2020, the outbreak of the novel coronavirus known as COVID- 19 changed the world in more ways than one. During the initial outbreak, health officials and the public were scrambling to mitigate the spread of the virus, but it didn't take long for those same individuals to recognize lingering side effects from COVID-19, which has since been termed "long COVID", and consist of side effects from the virus with varying lengths of staying with the previously infected individual, lasting from as little as a few days for up to years.
Recently, a team researchers from Dartmouth College examined a lingering COVID-19 symptom known as “prosopagnosia”, also called face blindness, in a 28-year-old customer service representative and part-time portrait artist, Annie. Two months after being diagnosed with COVID-19 in March 2020, Annie experienced what’s known as a symptom relapse, and had trouble with face recognition and navigation.
“When I first met Annie, she told me that she was unable to recognize the faces of her family,” said Marie-Luise Kieseler, who is a psychological and brain sciences graduate student at Dartmouth, and lead author of the study.
In June 2020, Annie was spending time with her family for the first time since her COVID-19 diagnosis and noticed difficulty in both recognizing her father and telling him apart from her uncle.
“My dad’s voice came out of a stranger’s face,” Annie recalls, who also states she heavily relies on voices to recognize people she knows.
Along with difficulty with face recognition, Annie has also experienced difficulty navigating familiar environments, such as a grocery store or remembering where she parked her car, the latter of which she relies on dropping a pin in Google Maps. She’s also experienced difficulty in cardinal directions, as well, saying she’s often driven in the opposite direction of where she wants to go.
“The combination of prosopagnosia and navigational deficits that Annie had is something that caught our attention because the two deficits often go hand in hand after somebody either has had brain damage or developmental deficits,” said Dr. Brad Duchaine, who is a professor of psychological and brain sciences at Dartmouth, and a co-author on the study. “That co-occurrence is probably due to the two abilities depending on neighboring brain regions in the temporal lobe.”
For the study, Annie participated in two tests to examine her face recognition concerns along with examining if she also has difficulty with other cognitive or perceptual abilities, as well.
The first test consisted of Annie observing 60 images of celebrity faces and tasked with naming them. This was followed by Annie being given a list of the celebrities featured in the image test and was tasked to see if she knew them. While most individuals can correctly identify 84 percent of the celebrities, Annie only correctly identified 29 percent of the 48 celebrities.
The second test consisted of Annie being given a celebrity name and two images, one image of the real celebrity and one image of someone who looked like them. While most individuals can correctly identify the real celebrity 80 percent of the time, Annie was only correctly identified the real celebrity 56 percent during the test.
“Our results from the test with unfamiliar faces show that it wasn’t just that Annie couldn’t recall the name or biographical information of a famous person that she was familiar with, but she really has trouble learning new identities,” said Kieseler.
While these two tests were low results, Annie was determined to have normal scores in face identity perception, object recognition, and face detection, along with demonstrating flawless scores with scene processing tests, where she observed a series of landscapes followed by a second set of the same images.
“This sort of dissociation like we’re seeing in Annie is seen in some people who have navigational deficits, where they can recognize where they are but when they’re asked where another place is relative to where they are right now, they struggle,” said Dr. Duchaine. “They have trouble understanding relationships between different places, which is a step beyond recognizing the place that you're in.”
Annie wasn’t the only participant for this study, as the researchers used self-reported data from 54 individuals who experienced long COVID symptoms for a minimum of 12 weeks, along with 32 individuals who reported they were fully recovered from the disease. The participants were asked to provide statements on their cognitive abilities before and after having COVID, including navigating their environment or recognizing television characters. The researchers then compared the long COVID group with the fully recovered group.
“Most respondents with long COVID reported that their cognitive and perceptual abilities had decreased since they had COVID, which was not surprising, but what was really fascinating was how many respondents reported deficits,” said Kieseler. “It was not just a small concentration of really impaired cases but a broad majority of people in the long COVID group reported noticeable difficulties doing things that they were able to do before contracting COVID-19 without any problems.”
“Our study highlights the sorts of perceptual problems with face recognition and navigation that can be caused by COVID-19 — it’s something that people should be aware of, especially physicians and other health care professionals,” said Dr. Duchaine.
Dr. Duchaine is the co-founder of faceblind.org, which is the Prosopagnosia Research Center and a collaboration between Dartmouth College, Harvard University, and the University of London, and encourages individuals who have experienced such cognitive declines from COVID-19 to contact the research team.
Sources: Centers for Disease Control and Prevention, Cortex, Faceblind.org
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