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Identifying the relationship between COVID-19, the effect of vaccination and medication, and accommodating non-COVID-19 factors to cognitive failure is essential. This study was conducted in Indonesia from September 2021 to January 2023. Demographic information, clinical data, comorbidities, vaccination, and medication during COVID-19 were obtained, as well as a 6-month cognitive assessment with Cognitive Failures Questionnaire\/CFQ, Fatigue Severity Score, and Generalized Anxiety Disorder (GAD-7). A Structural Equation Model explains the relationship between potential predictors and cognitive failure. The average score of CFQ after 6\u00a0months was 45.6\u2009\u00b1\u200923.1 out of 100. The severity of the disease, which was associated with vaccination status, age, previous infection, and unit of treatment (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.05), was not related to cognitive failure (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.519), although there is a significant direct impact of worst vaccination status to cognitive failure(\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). However, age, fatigue, and current anxiety were associated with higher cognitive failure (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), although comorbidities and recent headaches were not significant in other models (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&gt;\u20090.05). This study concludes that cognitive failure after COVID-19 is a multifactorial event and does not solely depend on COVID-19 severity. It is crucial to re-address the factors related to the long-term efficacy of vaccination and medication and focus on non-health factors affecting cognitive failure.\n                  <\/jats:p>\n                  <jats:p>Trial Registration: NCT05060562.<\/jats:p>","DOI":"10.1038\/s41598-023-46334-2","type":"journal-article","created":{"date-parts":[[2023,11,8]],"date-time":"2023-11-08T10:03:04Z","timestamp":1699437784000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Longitudinal study of disease severity and external factors in cognitive failure after COVID-19 among Indonesian population"],"prefix":"10.1038","volume":"13","clinical-trial-number":[{"clinical-trial-number":"nct05060562","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Bumi","family":"Herman","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin Chi Sang","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prawat","family":"Chantharit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Firdaus Fabrice","family":"Hannanu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pramon","family":"Viwattanakulvanid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,11,8]]},"reference":[{"key":"46334_CR1","unstructured":"Organization, W. 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