Hurtado Carolina, Rojas-Gualdrón Diego Fernando, Pérez Giraldo Gina S, Villegas Arbelaez Esteban, Mantilla Salvador Ernesto Medina, Campuzano-Sierra Mariana, Ospina-Patino Santiago, Arroyave-Bustamante Mariana, Uribe-Vizcarra Valeria, Restrepo-Arbelaez Daniel, Cardona Paul, Llano-Piedrahita Julián, Vásquez-Builes Santiago, Agudelo-Quintero Esteban, Vélez-Arroyave Juliana, Menges Sebastián, Jimenez Millenia, Miller Janet, Quique Yina M, Koralnik Igor J
School of Medicine, CES University, Medellín, Colombia.
Neurology Department, Medical University of South Carolina, Charleston, SC, United States.
Front Hum Neurosci. 2024 Aug 13;18:1450110. doi: 10.3389/fnhum.2024.1450110. eCollection 2024.
To analyze patient-reported outcomes, cognitive function, and persistent symptoms in patients with neurologic post-acute sequelae of SARS-CoV-2 infection (Neuro-PASC) in Colombia.
We recruited patients with laboratory-confirmed COVID-19 and PASC symptoms lasting more than 6 weeks at the CES University and CES Clinic (Medellín, Colombia). We included 50 post-hospitalization Neuro-PASC (PNP) and 50 non-hospitalized Neuro-PASC (NNP) patients. Long-COVID symptoms, cognitive (NIH Toolbox v2.1-Spanish for 18+), patient-reported (PROMIS) outcomes, and relevant medical history were evaluated. Statistical analyses were performed via generalized linear models.
Overall, brain fog (60%), myalgia (42%), and numbness or tingling (41%) were the most common neurological symptoms, while fatigue (74%), sleep problems (46%), and anxiety (44%) were the most common non-neurological symptoms. Compared to NNP, PNP patients showed a higher frequency of abnormal neurological exam findings (64% vs. 42%, = 0.028). Both groups had impaired quality of life (QoL) in domains of cognition, fatigue, anxiety depression and sleep disturbance, and performed worse on processing speed and attention than a normative population. In addition, NNP patients performed worse on executive function than PNP patients (T-score 42.6 vs. 48.5, = 0.012). PASC symptoms of anxiety and depression were associated with worse QoL and cognitive outcomes. Brain fog and fatigue remained persistent symptoms across all durations of Long COVID.
Our findings highlight the high incidence and heterogeneity of the neurologic symptoms and impacts of Long COVID even more than 2 years from disease onset. Early detection, emotional support and targeted management of Neuro-PASC patients are warranted.
分析哥伦比亚感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）后急性后遗症（神经型PASC）患者的患者报告结局、认知功能和持续症状。
我们在CES大学和CES诊所（哥伦比亚麦德林）招募了实验室确诊的COVID-19且PASC症状持续超过6周的患者。我们纳入了50名住院后神经型PASC（PNP）患者和50名非住院神经型PASC（NNP）患者。评估了长新冠症状、认知功能（适用于18岁及以上人群的NIH Toolbox v2.1西班牙语版）、患者报告结局（PROMIS）以及相关病史。通过广义线性模型进行统计分析。
总体而言，脑雾（60%）、肌痛（42%）以及麻木或刺痛感（41%）是最常见的神经症状，而疲劳（74%）、睡眠问题（46%）和焦虑（44%）是最常见的非神经症状。与NNP患者相比，PNP患者神经检查异常结果的频率更高（64%对42%，P = 0.028）。两组在认知、疲劳、焦虑抑郁和睡眠障碍等领域的生活质量（QoL）均受损，并且在处理速度和注意力方面的表现均比正常人群差。此外，NNP患者在执行功能方面的表现比PNP患者差（T分数42.6对48.5，P = 0.012）。焦虑和抑郁的PASC症状与较差的QoL和认知结局相关。在长新冠的所有病程中，脑雾和疲劳仍然是持续症状。
我们的研究结果凸显了长新冠神经症状的高发病率和异质性，以及即使在疾病发作两年多后其造成的影响。有必要对神经型PASC患者进行早期检测、给予情感支持和针对性管理。
