An Exploratory Analysis of Contributors to Cognitive Functioning Among Sexual and Gender Minority Individuals Who Had COVID-19

J Homosex. 2025 Jan 2;72(1):129-144. doi: 10.1080/00918369.2024.2309497. Epub 2024 Feb 2.

Abstract

Sexual and gender minority (SGM) individuals face mental health disparities. However, research analyzing SGM people's mental health after a COVID-19 diagnosis is scarce. In this secondary analysis of a remote study, we 1) examined associations between cognitive and psychosocial health and 2) explored differences between these health outcomes among SGM (n = 14) and heterosexual cisgender (n = 64) U.S. adults who had COVID-19. We used the Patient Reported Outcome Measures Information System (PROMIS) v2.0 to assess subjective cognition and the BrainCheck cognitive test to analyze objective cognition. We administered the Perceived Stress Scale and PROMIS 57 Profile V.2.0 to measure psychosocial health. SGM COVID-19 survivors had worse scores in depression, anxiety, sleep disturbance, pain, stress, and objective cognition than heterosexual cisgender participants (p-values < .05). Objective cognition was associated with age, SGM classification, racial or ethnic minority classification, income, comorbidities, COVID-19 severity, number of symptoms, and pain (|0.137| < r < |0.373|, p-values < .05). Subjective cognition was associated with comorbidities, number of symptoms, depression, anxiety, sleep disturbance, pain, and stress (|0.158| < r < |0.537|, p-values < .05). Additional studies are needed to expand what is known about post-COVID-19 health disparities and to guide policies and interventions that promote cognitive functioning.

Keywords: COVID-19; Sexual and gender minorities; cognitive function; healthcare disparities; psychosocial functioning.

MeSH terms

  • Adult
  • Aged
  • Anxiety
  • COVID-19* / psychology
  • Cognition*
  • Depression
  • Female
  • Health Status Disparities
  • Humans
  • Male
  • Middle Aged
  • SARS-CoV-2
  • Sexual and Gender Minorities* / psychology
  • Stress, Psychological
  • United States