Huff Hanalise V, Villanueva-Colina Carla, Diaz Monica M, Tovar Sofia, Davila Luna Andrea, Wu Tianxia, Hamer Davidson H, Koralnik Igor J, Solomon Tom, Caniza Miguela A, Garcia Patricia J
Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, United States.
Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States.
Front Neurol. 2025 Jul 21;16:1524613. doi: 10.3389/fneur.2025.1524613. eCollection 2025.
There is limited research on long-term neurologic symptoms following SARS-CoV-2 infection in Peru. This study aimed to describe the longitudinal experience of survivors of mild to moderate COVID-19 in Lima, Peru.
This prospective, longitudinal observational study included neurologic follow-up data between 3- and 12-months following SARS-CoV-2 infection. Recruitment to a parent study: "Natural History of SARS-CoV-2 in Comparison to Influenza Virus: A Multi-site Study Focused on the Southern Hemisphere and Equatorial Regions" (COFLU Peru), occurred between February 2021 and February 2022 in a Callao, Peru public hospital emergency department. In-person visits for this sub-study, "Neuro COFLU," included neurologic history and symptom questionnaire.
Fifty-four patients were seen for at least one visit, two of whom required hospitalization for COVID-19. Forty-one (76%) reported at least one pre-existing neurologic diagnosis (59% headaches; 24% migraines). At follow-up visits, patients reported at least one new neurologic symptom since COVID-19: 24/29 (83%) at 90 days, 31/42 (74%) at 180 days, 41/46 (89%) at 270 days, and 20/21 (95%) at 365 days. The median number of new symptoms was 3 at 90 days, 3 at 180, 4 at 270 and 3 at 365 days. Days 90-180 frequent symptoms included: muscular pain, neck stiffness, headache, loss of appetite, numbness, insomnia, and weakness (24-31%). Days 181-365 frequent symptoms included: fatigue, weakness, memory problems, irritability, changes in hearing, muscular pain, joint pain, and insomnia (28-33%). Pre-existing anxiety was associated with post-COVID-19 hearing changes, muscular pain, numbness and weakness and pre-existing depression with neck stiffness and numbness. No significant association was found with age, sex, vaccination status, or pre-existing headaches. Full recovery was reported for 6/29 (21%) at day 90, 13/42 (31%) at day 180, 17/46 (37%) at day 270, and 9/20 (45%) at day 365. By day 365, patients reported median recovery of 85-90%.
Persistent neurological symptoms are common in COVID-19 survivors in Lima. Many new neurologic symptoms persisted and increased in prevalence over 3-12 months. Limitations include lack of control group and small sample size. Longitudinal studies of outcomes are needed to predict and mitigate the long-term physical, social and economic effects of SARS-CoV-2 infection.
在秘鲁，关于新型冠状病毒2（SARS-CoV-2）感染后的长期神经症状研究有限。本研究旨在描述秘鲁利马轻度至中度新冠肺炎幸存者的纵向经历。
这项前瞻性、纵向观察性研究纳入了SARS-CoV-2感染后3至12个月的神经学随访数据。在一项母研究“与流感病毒相比，SARS-CoV-2的自然史：一项聚焦于南半球和赤道地区的多中心研究”（秘鲁COFLU）中进行招募，于2021年2月至2022年2月在秘鲁卡亚俄的一家公立医院急诊科进行。这项子研究“神经COFLU”的面对面访视包括神经病史和症状问卷。
54名患者至少接受了一次访视，其中两名因新冠肺炎需要住院治疗。41名（76%）报告至少有一种既往神经诊断（59%头痛；24%偏头痛）。在随访访视中，患者报告自感染新冠肺炎后至少出现一种新的神经症状：90天时24/29（83%），180天时31/42（74%），270天时41/46（89%），365天时20/21（95%）。新症状的中位数在90天时为3个，180天时为3个，270天时为4个，365天时为3个。90至180天常见症状包括：肌肉疼痛、颈部僵硬、头痛、食欲不振、麻木、失眠和虚弱（24%-31%）。181至365天常见症状包括：疲劳、虚弱、记忆问题、易怒、听力变化、肌肉疼痛、关节疼痛和失眠（28%-33%）。既往焦虑与新冠肺炎后的听力变化、肌肉疼痛、麻木和虚弱相关，既往抑郁与颈部僵硬和麻木相关。未发现与年龄、性别、疫苗接种状况或既往头痛有显著关联。90天时6/29（21%）报告完全康复，180天时13/42（31%），270天时17/46（37%），365天时9/20（45%）。到365天时，患者报告中位数康复率为85%-90%。
在利马的新冠肺炎幸存者中，持续性神经症状很常见。许多新的神经症状持续存在且在3至12个月内患病率增加。局限性包括缺乏对照组和样本量小。需要对结果进行纵向研究，以预测和减轻SARS-CoV-2感染的长期身体、社会和经济影响。
