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. 2023 Sep;30(9):2713-2725.
doi: 10.1111/ene.15923. Epub 2023 Jun 28.

Reported neurological symptoms after severe acute respiratory syndrome coronavirus type 2 infection: A systematic diagnostic approach

Birgit Ludwig  1   2 , Matthias Deckert  1   2 , Nik Krajnc  1   2 , Omar Keritam  1   2 , Stefan Macher  1   2 , Gabriel Bsteh  1   2 , Gudrun Zulehner  1   2 , Majda Thurnher  3 , Thomas Berger  1   2 , Stefan Seidel  1   2   4 , Ulrike Willinger  1   2 , Paulus Rommer  1   2
Affiliations

Reported neurological symptoms after severe acute respiratory syndrome coronavirus type 2 infection: A systematic diagnostic approach

Birgit Ludwig et al. Eur J Neurol. 2023 Sep.

Abstract

Background and purpose: 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 semistandardized 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%), of which 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, or 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.

Conclusions: 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 also suspect a link between the growing burden of the COVID-19 pandemic on personal lives and the increase in reported neurological and psychiatric complaints.

Keywords: brain fog; cognitive impairment; fatigue; hyposmia; neurological post-COVID-19 symptoms; post-COVID-19 syndrome.

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References

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