Even a mild case of COVID-19 can damage the brain and addle thinking, scientists found in a study that highlights the illness’s alarming impact on mental function.

Researchers identified COVID-associated brain damage months after infection, including in the region linked to smell, and shrinkage in size equivalent to as much as a decade of normal aging. The changes were linked to cognitive decline in the study, which was published Monday in the journal Nature.

The findings represent striking evidence of the virus’s impact on the central nervous system. More research will be required to understand whether the evidence from the Wellcome Centre for Integrative Neuroimaging at the University of Oxford means COVID-19 will exacerbate the global burden of dementia.

“It is a very novel study with conclusive data,” said Avindra Nath, clinical director of the U.S. National Institute of Neurological Disorders and Stroke, who wasn’t involved in the research. “The findings are very intriguing, with important implications for the population at large.”

Effects like impaired concentration, headache, sensory disturbances, depression, and even psychosis may persist for months as part of a constellation of symptoms termed long COVID.

MRI scans of the brains of 785 volunteers were taken before the pandemic began as part of U.K. Biobank research, which marries large-scale genomic and detailed clinical data for half a million people.

A subsequent scan was taken an average of 38 months later. By then, 401 participants had tested positive for COVID. The uninfected remainder served as a control group that was similar to the survivors in risk factors, The participants in the study were aged 51 to 81.

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