Most non-hospitalized “long haulers” coronaviruses, or patients who experience symptoms more than a month later, report more than four neurological symptoms, with “brain fog” being the most prevalent, according to what the researchers say is the first study of its kind.
A team of Northwestern Medicine experts published peer-reviewed findings in the Annals of Clinical and Translational Neurology on Tuesday. The study aimed to characterize the range of neurological manifestations that “long distance trucks” suffer. The researchers looked at 100 out-of-hospital long haulers, 50 of whom had confirmed positive virus tests and 50 not. The average age of the participants was 43, and the majority of the participants were female.
The results indicated that 85% of the 100 “long haulers” experienced at least four neurological symptoms, the most frequent of which were brain fog, headache, numbness, taste and smell disorder and muscle pain. This does not include non-neurological symptoms; many patients experienced fatigue, while still others reported shortness of breath and chest pain, among other symptoms.
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“Our study is the first to report neurological findings in out-of-hospital COVID-19 long-haulers, including detailed neurological examination, diagnostic tests and validated measures of the patient’s quality of life, as well as results of cognitive function tests,” said Dr Igor Koralnik, head of neuro-infectious diseases and global neurology at Northwestern Medicine’s Ken & Ruth Davee Neurology Department, in a related statement.
“At the beginning of the pandemic, patients with mild illness often did not qualify for the nasal swab or the serology test,” explained Koralnik. “Because of this, we included 50 long-haulers with positive laboratory tests and 50 with negative laboratory tests. All patients in this study had clinical symptoms consistent with COVID-19, but only had mild and transient respiratory symptoms (sore throat, cough, low fever) and never developed pneumonia or low oxygen levels that required hospitalization. “
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Noteworthy, almost half of the group reported depression / anxiety before the diagnosis of coronavirus. Koralnik suggested that this presented a “possible neuropsychiatric vulnerability” to persistent symptoms associated with “long COVID”.
After five months, participants said that their conditions had not yet fully improved; on average, they reported feeling 64% recovered. The study authors noted that long haulers tend to improve over time, but some still experience symptoms that last nine months later.
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The treatment involved “cognitive rehabilitation,” and Northwestern doctors are also investigating some “therapeutic interventions,” according to the release. In the meantime, the researchers are also investigating persistent neurological symptoms in patients with COVID-19 who have had a severe course of the disease.
“Future extended studies are needed to assess cognitive impacts on long-haulers and design appropriate treatment options,” wrote Koralnik.