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Eur J Neurol . Reported neurological symptoms after severe acute respiratory syndrome coronavirus type 2 (SARS CoV-2) infection: a systematic diagn

tetano

Editor, Senior Moderator
Eur J Neurol


. 2023 Jun 12.
doi: 10.1111/ene.15923. Online ahead of print. Reported neurological symptoms after severe acute respiratory syndrome coronavirus type 2 (SARS CoV-2) infection: a systematic diagnostic approach

B Ludwig[SUP] 1 2 [/SUP], M Deckert[SUP] 1 2 [/SUP], N Krajnc[SUP] 1 2 [/SUP], O Keritam[SUP] 1 2 [/SUP], S Macher[SUP] 1 2 [/SUP], G Bsteh[SUP] 1 2 [/SUP], G Zulehner[SUP] 1 2 [/SUP], M Thurnher[SUP] 3 [/SUP], T Berger[SUP] 1 2 [/SUP], S Seidel[SUP] 1 2 4 [/SUP], U Willinger[SUP] 1 2 [/SUP], P Rommer[SUP] 1 2 [/SUP]



Affiliations
Abstract

Introduction: Following increasing demands of patients with suspected neurological symptoms after infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), the Department of Neurology at the Medical University of Vienna established a new outpatient clinic to systematically assess, diagnose and document neurological complaints potentially associated with a prior SARS-CoV-2 infection.
Methods: The data presented here include prospectively collected 156 outpatients from May 2021 to April 2022. Patients underwent semi-standardized interviewing about symptoms with reported onset after SARS CoV-2 infection, neurological examination, and comprehensive diagnostic workup.
Results: Reported new-onset symptoms after infection included fatigue (77.6%), subjective cognitive impairment (72.4%), headache (47.7%), loss of smell and/or taste (43.2%), and sleep disturbances (42.2%). Most patients had a mild coronavirus disease (COVID-19) disease course (84%) and reported comorbidities (71%), thereof the most frequent were psychiatric disorders (34%). Frequency of symptoms was not associated with age, sex, or severity of COVID-19 course. A comprehensive diagnostic workup revealed no neurological abnormalities in the clinical examination, electrophysiological, or imaging assessments in the majority of patients (n=143, 91.7%). Neuropsychological assessment of a subgroup of patients (n = 28, 17.9%) showed that cognitive impairments in executive functions and attention, anxiety, depression, and somatization symptoms were highly common.
Conclusion: In this systematic registry we identified fatigue, cognitive impairment, and headache as the most frequently reported persisting complaints after SARS-CoV-2 infection. Structural neurological findings were rare. We suspect a link between the growing burden of the COVID pandemic on personal lives and the increase in reported neurological and psychiatric complaints.

Keywords: Cognitive Impairment; Fatigue; Hyposmia; Neurological Post-COVID Symptoms; Post-COVID-19 syndrome; ‘Brainfog’.

 
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