Neurological symptoms can last for more than a year in patients with long COVID

New research published in Annual clinical and translational neurology report Patients recovering from coronavirus disease (COVID-19) in 2019 have long been reported-COVID symptomsAnd if you did not require hospitalization during the infection, you may experience persistent neurological symptoms, malaise, and poor quality of life (QoL) for a median of 14.8 months after the initial infection. ..

study: Progression of neurological symptoms in COVID-19 “long-distance carrier” not hospitalized. Image Credits: fizkes / Shutterstock.com

Background

Despite recent advances in the diagnosis, treatment and prevention of COVID-19, combined with the approval and widespread distribution of numerous targeted vaccines, the long-term effects of this disease have not yet been defined. ..

Many patients who experienced a long-term infection with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) were subsequently diagnosed with lung, heart, gastrointestinal, and neurological dysfunction. These individuals are often referred to as “long-distance transporters,” and long-term COVID-19-related symptoms are collectively referred to as SARS-CoV-2 infection (PASC) or the acute sequelae of long-term COVID syndrome.

In addition to this subset of patients, those who experienced mild respiratory symptoms during the acute phase of infection and those who had no history of hospitalization associated with pneumonia or hypoxemia were also PASC (Neuro PASC). Most long-term COVID studies include COVID-19 patients with previous hospitalizations. However, the long-term effects of SARS-CoV-2 infection in unhospitalized patients remain largely unknown.

In addition, the impact of the COVID-19 vaccine on long-term COVID remains unclear.

About research

In the current study, 50 patients with no history of hospitalization were selected from a pool of COVID-19 patients, and 50 patients who were negative for COVID-19 were selected as controls.

These 100 patients were monitored for 6-9 months to track the development and resolution of cognitive function. Cognitive function is responsible for the documented “brain fog” reported in long-COVID along with self-reported quality of life. Patient-perceived recovery, cognition, and malaise were also characterized in vaccinated and unvaccinated individuals.

Survey results

At a median of 9.2 months from the initial diagnosis of COVID-19, no significant changes were reported in the frequency of COVID-19-related neurological and non-neurological symptoms. Finally, researchers found that the continuous symptom burden of long-COVID persisted for a median of 14.8 months after the onset of symptoms.

Due to the long duration of COVID symptoms, more than 50% of long-haul carriers in this study have tried various treatments to relieve the symptoms. These include alternatives / supplements, neuropathic analgesics, and antidepressants. On the other hand, anosmia and dysgeusia decreased over time, suggesting that the dysfunction of the sense of smell and taste disappeared spontaneously.

Nonetheless, during the follow-up period, significant increases in heart rate and blood pressure abnormalities, and gastrointestinal symptoms were reported. Continuous cytokine release or other viral mediation mechanisms have been speculated as possible causes of this autonomic dysfunction, as these factors are likely to be the cause of these symptoms.

Overall, both COVID-19-positive and COVID-19-negative individuals reported improved subjective impressions of recovery. This was significant in COVID-19 positive patients. Elimination of symptomatic substance use, anosmia and dysgeusia, and reduction of symptomatic severity may contribute to improved patient perception.

Compared to the first clinic visit, both COVID-19-positive and COVID-19-negative patients reported improved cognitive function and reduced fatigue at follow-up visits. Despite these obvious improvements, both groups reported significantly worse quality of life scores for both cognitive function and fatigue compared to the median score for the general US population. In particular, low cognitive function scores were significantly associated with fatigue, anxiety, depression, and worsening sleep disorders.

Both vaccinated and unvaccinated individuals, consisting of 40 and 10, respectively, reported improved subjective impressions of recovery on follow-up visits. Vaccinated individuals showed a significant improvement in cognitive function score at follow-up, but neither vaccinated nor unvaccinated individuals showed an improvement in fatigue score.

Conclusion

Long-COVID continues to adversely affect the quality of life of many people around the world. Current studies have shown that patients suffering from long-term COVID continue to experience a variety of neurological symptoms for over a year after recovering from the initial infection. These findings underscore the need for researchers to conduct additional studies to better understand the mechanisms responsible for these persistent neurological symptoms in patients with long-term COVID.

It should be noted that the results reported in the current study were obtained from patients infected with the early SARS-CoV-2 strain. Nonetheless, these results may help determine the potential long-term effects of infection with the more recent SARS-CoV-2 strain.