COVID-19 on the brain: Neurological symptoms persist in majority of long-haulers – Neuroscience News

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Summary: Six months after COVID-19 infection, two-thirds of patients still had neurological symptoms, including headaches, memory problems and decreased concentration, which impacted their quality of life .

Source: UCSD

Researchers at the University of California San Diego School of Medicine are conducting a longitudinal study to track neurological symptoms in COVID-19 “long haulers”.

The first round of results, published on June 15, 2022 in Annals of Clinical and Translational Neurologyrevealed the prevalence of various short- and long-term symptoms and found that although many patients showed improvement, the majority still had neurological symptoms after six months.

A subset of individuals also had significant coordination and cognitive problems, which had not been previously described.

Following mild to moderate SARS-CoV-2 infections, 56 individuals with neurological symptoms were recruited to the study between October 2020 and October 2021. They completed a neurological examination, cognitive assessment, questionnaires self-reported and an optional brain scan. Baseline measurements were taken a few months after their initial infection and repeated three and six months later.

At the time of their first visit, 89% of participants experienced fatigue and 80% reported headaches. Other common neurological symptoms included memory impairment, insomnia, and decreased concentration. Eighty percent of participants said these symptoms impacted their quality of life.

When participants returned for their six-month follow-up, only a third reported complete resolution of symptoms. The other two-thirds of participants reported persistent neurological symptoms, although most decreased in severity. The most common symptoms at six months were memory problems and decreased concentration.

The authors noted that none of the people with persistent symptoms at six months had a history of pre-existing neurological conditions prior to their SARS-CoV-2 infections.

“It’s encouraging that most people were showing some improvement at six months, but that wasn’t the case for everyone,” said lead author Jennifer S. Graves, MD, PhD, associate professor at UC San Diego School of Medicine and a neurologist at UC. San Diego Health.

“Some of these participants are high-level professionals who would be expected to score above average on cognitive assessments, but months after having COVID-19 they are still scoring abnormally high. ”

The researchers were also surprised to find a new phenotype within the cohort. Seven percent of participants had a previously unidentified set of symptoms, including cognitive deficits, tremors and difficulty with balance. The authors labeled the phenotype Post-Acute Sequelae of COVID-19 infection with Tremor, Ataxia and Cognitive deficit (PASC-TAC).

At the time of their first visit, 89% of participants experienced fatigue and 80% reported headaches. Image is in public domain

“These are people who had no neurological issues before COVID-19, and now they have incoordination in their bodies and possible incoordination in their thoughts,” Graves said. “We didn’t expect to find this, so we want to spread the word in case other doctors see this too.”

Researchers are still studying the extent to which the SARS-CoV-2 virus directly invades the brain, but Graves said it’s more likely that these delayed neurological symptoms are caused by the infection triggering an inflammatory autoimmune response in the brain. .

The team plans to continue monitoring participants’ symptoms annually for up to 10 years. Further efforts will assess how different COVID-19 variants and vaccines affect long-term neurological symptoms.

“For people’s cognition and quality of life to still be affected so long after infection, that’s something we as a society need to seriously look at,” Graves said. “We still need to know how common this is, what biological processes cause it, and what ongoing health care these people will need. This work is an important first step in getting there.

Co-authors include: Jacqueline E. Shanley, Andrew F. Valenciano, Garrett Timmons, Annalize E. Miner, Visesha Kakarla, Jennifer H. Yang, Amanda Gooding, Marc A. Norman, Sarah J. Banks, NeuCovid Team, Michelle L Ritter, Ronald J. Ellis and Lucy Horton at UC San Diego, as well as Torge Rempe at the University of Florida.

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About this long-running COVID and neurology research news

Author: Nicole Mlynaryk
Source: UCSD
Contact: Nicole Mlynaryk – UCSD
Image: Image is in public domain

Original research: Free access.
Longitudinal evaluation of post-acute neurological sequelae of symptoms of SARS-CoV-2 infection” by Jennifer S. Graves et al. Annals of Clinical and Translational Neurology


Longitudinal evaluation of post-acute neurological sequelae of symptoms of SARS-CoV-2 infection


To assess the baseline characteristics and course of postacute neurological sequelae of SARS-CoV-2 (neuro-PASC) infection in patients with and without prior neurological disease.


Participants with neurological symptoms following acute SARS-CoV-2 infection were recruited from October 9, 2020 to October 11, 2021. Clinical data included a history of SARS-CoV-2 infection, a systems neurological examination, a neurological examination, a Montreal Cognitive Assessment (MoCA), and self-reported symptom-based surveys at baseline (performed after acute infection) and follow-up assessments at 6 months.


Fifty-six participants (69% female, mean age 50, 29% with prior neurological disease such as multiple sclerosis) were enrolled, 27 of whom had completed the 6-month follow-up visit in this ongoing study . The severity of SARS-CoV-2 infection was widely described as mild (39.3%) or moderate (42.9%). At baseline, after an acute infection, the most common neurological symptoms were fatigue (89.3%) and headache (80.4%). At 6-month follow-up, memory impairment (68.8%) and decreased concentration (61.5%) were the most common, although on average all symptoms showed a reduction in score. severity reported at follow-up. Complete resolution of symptoms was reported in 33.3% of participants at 6 months. From baseline to 6 months, mean MoCA scores improved overall, although 26.3% of participants’ scores decreased. A syndrome composed of tremors, ataxia and cognitive dysfunction (PASC-TAC) was observed in 7.1% of patients.


At the onset of neuro-PASC syndrome, fatigue and headaches are the most commonly reported symptoms. At 6 months, memory impairment and decreased concentration were the most significant. Only one-third of participants had completed neuro-PASC resolution at 6 months, although persistent symptoms tended to improve at follow-up.

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