Grisanti Stefano Giuseppe, Garbarino Sara, Bellucci Margherita, Schenone Cristina, Candiani Valentina, Di Lillo Simmaco, Campi Cristina, Barisione Emanuela, Aloè Teresita, Tagliabue Elena, Serventi Alberto, Pesce Giampaola, Massucco Sara, Cabona Corrado, Lechiara Anastasia, Uccelli Antonio, Schenone Angelo, Piana Michele, Benedetti Luana
Struttura Complessa Neurologia P.O. Ponente, Dipartimento Testa-Collo, Ospedale Santa Corona, Pietra Ligure, Italy.
Life Science Computational Laboratory, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Eur J Neurol. 2025 Mar;32(3):e16510. doi: 10.1111/ene.16510.
Neurological involvement in long COVID (coronavirus disease 2019) is well known. In a previous study we identified two subtypes of neurological long COVID, one characterized by memory disturbances, psychological impairment, headache, anosmia and ageusia, and the other characterized by peripheral nervous system involvement, each of which present a different risk factor profile. In this study, we aimed to clarify the persistence of neurological long COVID symptoms with a significantly longer term follow-up.
We prospectively collected data from patients with prior COVID-19 infection who showed symptoms of neurological long COVID. We conducted a descriptive analysis to investigate the progression of neurological symptoms over time at 3-, 6-, 12-, and 18-month follow-ups. We performed a k-means clustering analysis on the temporal evolution of the symptoms at 6, 12, and 18 months. Finally, we assessed the difference between the recovery course of vaccinated and non-vaccinated patients by computing the cumulative recovery rate of symptoms in the two groups.
The study confirmed the presence of two subtypes of neurological long COVID. Further, 50% of patients presented a complete resolution of symptoms at 18 months of follow-up, regardless of which subtype of neurological long COVID they had. Vaccination against SARS-Cov-2 appeared to imply a higher overall recovery rate for all neurological symptoms, although the statistical reliability of this finding is hampered by the limited sample size of the unvaccinated patients included in this study.
Neurological long COVID can undergo complete resolution after 18 months of follow-up in 50% of patients and vaccination can accelerate the recovery.
新型冠状病毒肺炎（COVID-19）长期后遗症中的神经受累情况已为人熟知。在之前的一项研究中，我们确定了神经型长期COVID的两种亚型，一种以记忆障碍、心理损伤、头痛、嗅觉丧失和味觉丧失为特征，另一种以外周神经系统受累为特征，每种亚型都有不同的风险因素特征。在本研究中，我们旨在通过显著更长时间的随访来阐明神经型长期COVID症状的持续情况。
我们前瞻性地收集了先前感染COVID-19且出现神经型长期COVID症状患者的数据。我们进行了描述性分析，以研究在3个月、6个月、12个月和18个月随访时神经症状随时间的进展情况。我们对6个月、12个月和18个月时症状的时间演变进行了k均值聚类分析。最后，我们通过计算两组症状的累积恢复率来评估接种疫苗和未接种疫苗患者恢复过程的差异。
该研究证实了神经型长期COVID存在两种亚型。此外，50%的患者在随访18个月时症状完全缓解，无论他们患有哪种神经型长期COVID亚型。针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的疫苗接种似乎意味着所有神经症状的总体恢复率更高，尽管本研究中纳入的未接种疫苗患者样本量有限，这一发现的统计可靠性受到了影响。
50%的患者在随访18个月后神经型长期COVID可完全缓解，接种疫苗可加速恢复。
