Mary Wilson
New member
First published: 23 March 2021
https://doi.org/10.1002/acn3.51350
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record.
Edith L Graham, Jeffrey R Clark, Zachary S Orban, Patrick H Lim, April L Szymanski, Carolyn Taylor, Rebecca M DiBiase, Dan Tong Jia, Roumen Balabanov, Sam U Ho, Ayush Batra, Eric M Liotta, Igor J Koralnik
Abstract
Objective
Most SARS?CoV?2?infected individuals never require hospitalization. However, some develop prolonged symptoms. We sought to characterize the spectrum of neurologic manifestations in non?hospitalized Covid?19 ?long haulers?.
Methods
This is a prospective study of the first 100 consecutive patients (50 SARS?CoV?2 laboratory?positive and 50 laboratory?negative individuals) presenting to our Neuro?Covid?19 clinic between May and November 2020. Due to early pandemic testing limitations, patients were included if they met Infectious Diseases Society of America symptoms of Covid?19, were never hospitalized for pneumonia or hypoxemia and had neurologic symptoms lasting over 6 weeks. We recorded the frequency of neurologic symptoms and analyzed patient?reported quality of life measures and standardized cognitive assessments.
Results
Mean age was 43.2?11.3 years, 70% were female and 48% were evaluated in televisits. The most frequent comorbidities were depression/anxiety (42%) and autoimmune disease (16%). The main neurologic manifestations were: ?brain fog? (81%), headache (68%), numbness/tingling (60%), dysgeusia (59%), anosmia (55%), myalgias (55%), with only anosmia being more frequent in SARS?CoV?2[SUP]+[/SUP] than SARS?CoV?2[SUP]?[/SUP] patients (37/50 [74%] vs (18/50 [36%]; p <0.001). Moreover, 85% also experienced fatigue. There was no correlation between time from disease onset and subjective impression of recovery. Both groups exhibited impaired quality of life in cognitive and fatigue domains. SARS?CoV?2[SUP]+[/SUP] patients performed worse in attention and working memory cognitive tasks compared to a demographic?matched US population (T?score 41.5 [37, 48.25] and 43 [37.5, 48.75], respectively; both p<0.01).
Interpretation
Non?hospitalized Covid?19 ?long haulers? experience prominent and persistent ?brain fog? and fatigue that affect their cognition and quality of life.
PDF Format:
https://onlinelibrary.wiley.com/doi/...002/acn3.51350
https://doi.org/10.1002/acn3.51350
This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record.
Edith L Graham, Jeffrey R Clark, Zachary S Orban, Patrick H Lim, April L Szymanski, Carolyn Taylor, Rebecca M DiBiase, Dan Tong Jia, Roumen Balabanov, Sam U Ho, Ayush Batra, Eric M Liotta, Igor J Koralnik
Abstract
Objective
Most SARS?CoV?2?infected individuals never require hospitalization. However, some develop prolonged symptoms. We sought to characterize the spectrum of neurologic manifestations in non?hospitalized Covid?19 ?long haulers?.
Methods
This is a prospective study of the first 100 consecutive patients (50 SARS?CoV?2 laboratory?positive and 50 laboratory?negative individuals) presenting to our Neuro?Covid?19 clinic between May and November 2020. Due to early pandemic testing limitations, patients were included if they met Infectious Diseases Society of America symptoms of Covid?19, were never hospitalized for pneumonia or hypoxemia and had neurologic symptoms lasting over 6 weeks. We recorded the frequency of neurologic symptoms and analyzed patient?reported quality of life measures and standardized cognitive assessments.
Results
Mean age was 43.2?11.3 years, 70% were female and 48% were evaluated in televisits. The most frequent comorbidities were depression/anxiety (42%) and autoimmune disease (16%). The main neurologic manifestations were: ?brain fog? (81%), headache (68%), numbness/tingling (60%), dysgeusia (59%), anosmia (55%), myalgias (55%), with only anosmia being more frequent in SARS?CoV?2[SUP]+[/SUP] than SARS?CoV?2[SUP]?[/SUP] patients (37/50 [74%] vs (18/50 [36%]; p <0.001). Moreover, 85% also experienced fatigue. There was no correlation between time from disease onset and subjective impression of recovery. Both groups exhibited impaired quality of life in cognitive and fatigue domains. SARS?CoV?2[SUP]+[/SUP] patients performed worse in attention and working memory cognitive tasks compared to a demographic?matched US population (T?score 41.5 [37, 48.25] and 43 [37.5, 48.75], respectively; both p<0.01).
Interpretation
Non?hospitalized Covid?19 ?long haulers? experience prominent and persistent ?brain fog? and fatigue that affect their cognition and quality of life.
PDF Format:
https://onlinelibrary.wiley.com/doi/...002/acn3.51350