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ORIGINAL RESEARCH article

Front. Hum. Neurosci.
Sec. Brain Health and Clinical Neuroscience
Volume 18 - 2024 | doi: 10.3389/fnhum.2024.1450110
This article is part of the Research Topic Updating Long COVID: Mechanisms, Risk Factors, and Treatment Volume II View all articles

Neurologic manifestations of Long COVID in Colombia: A Comparative Analysis of post-Hospitalization vs. Non-hospitalized patients

Provisionally accepted
Carolina Hurtado Carolina Hurtado 1*Diego F. Rojas Gualdrón Diego F. Rojas Gualdrón 1Gina S. Pérez Giraldo Gina S. Pérez Giraldo 2Esteban Villegas Arbeláez Esteban Villegas Arbeláez 3Salvador E. Medina Mantilla Salvador E. Medina Mantilla 3Mariana Campuzano-Sierra Mariana Campuzano-Sierra 1Santiago Ospina-Patino Santiago Ospina-Patino 1Mariana Arroyave-Bustamante Mariana Arroyave-Bustamante 1Valeria Uribe-Vizcarra Valeria Uribe-Vizcarra 1Daniel Restrepo-Arbelaez Daniel Restrepo-Arbelaez 1Paul Cardona Paul Cardona 1Julián Llano-Piedrahita Julián Llano-Piedrahita 1Santiago Vásquez-Builes Santiago Vásquez-Builes 1Esteban Agudelo-Quintero Esteban Agudelo-Quintero 1Juliana Vélez-Arroyave Juliana Vélez-Arroyave 1Sebastian Menges Sebastian Menges 1Millenia Jimenez Millenia Jimenez 4Janet Miller Janet Miller 4Yina M. Quique Yina M. Quique 5Igor J. Koralnik Igor J. Koralnik 4
  • 1 School of Medicine, CES University, Medellín, Colombia
  • 2 Neurology Department, Medical University of South Carolina, Charleston, South Carolina, United States
  • 3 Clínica CES, Universidad CES, Medellín, Antioquia, Colombia
  • 4 The Ken & Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States
  • 5 Shirley Ryan AbilityLab, Chicago, Illinois, United States

The final, formatted version of the article will be published soon.

    Objective. 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. Methods. We recruited patients with laboratory-confirmed COVID-19 and persistent PASC symptoms lasting more than six 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. Results. 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%, p = 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, p = 0.012). Persistent 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. Conclusions. Our findings highlight the high incidence and heterogeneity of the neurologic symptoms and impacts of Long COVID even more than two years from disease onset. Early detection, emotional support and targeted management of Neuro-PASC patients are warranted.

    Keywords: COVID-19, post-acute COVID-19 syndrome, Neurologic Manifestations, cognitive dysfunction, Patient reported outcome measures

    Received: 16 Jun 2024; Accepted: 02 Aug 2024.

    Copyright: © 2024 Hurtado, Rojas Gualdrón, Pérez Giraldo, Villegas Arbeláez, Medina Mantilla, Campuzano-Sierra, Ospina-Patino, Arroyave-Bustamante, Uribe-Vizcarra, Restrepo-Arbelaez, Cardona, Llano-Piedrahita, Vásquez-Builes, Agudelo-Quintero, Vélez-Arroyave, Menges, Jimenez, Miller, Quique and Koralnik. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Carolina Hurtado, School of Medicine, CES University, Medellín, Colombia

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