Persistent Neurological Symptoms and Cognitive Dysfunction in Nonhospitalized Covid-19 “Long Distance Carriers” – Graham – – Annals of Clinical and Translational Neurology


Aim

Most people infected with SARS – CoV – 2 never require hospitalization. However, some develop prolonged symptoms. We attempted to characterize the spectrum of neurological manifestations in non-hospitalized Covid-19 “long-distance carriers”.

Methods

This is a prospective study of the first 100 consecutive patients (50 SARS – CoV – 2 patients with positive laboratory results and 50 with negative laboratory results) who presented at our Neuro – Covid – 19 clinic between May and November 2020. Due to the limitations of early pandemic testing, patients were included if they had symptoms of Covid-19 from the Infectious Diseases Society of America, were never hospitalized for pneumonia or hypoxemia, and had neurological symptoms lasting more than 6 weeks. The frequency of neurological symptoms was recorded, and patient-reported quality of life measures and standardized cognitive assessments were analyzed.

Results

The mean age was 43.2 ± 11.3 years, 70% were women and 48% were evaluated on televisions. The most frequent comorbidities were depression / anxiety (42%) and autoimmune disease (16%). The main neurological manifestations were: “mental fog” (81%), headache (68%), numbness / tingling (60%), dysgeusia (59%), anosmia (55%), myalgia (55%), with only anosmia being more frequent in SARS – CoV – 2+ than SARS – CoV – 2 patients (37/50 [74%] in front of (18/50 [36%]; p <0.001). Additionally, 85% also experienced fatigue. There was no correlation between the time elapsed since the onset of the disease and the subjective impression of recovery. Both groups exhibited impaired quality of life in the cognitive and fatigue domains. SARS-CoV-2+ patients performed worse on cognitive tasks of attention and working memory compared to a US population. [37, 48.25] and 43 [37.5, 48.75], respectively; both p <0.01).

Interpretation

Out-of-hospital “long-haul carriers” of Covid-19 experience prominent and persistent “brain fog” and fatigue affecting their cognition and quality of life.

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