2023 American Academy of Neurology Abstract Website

Sherry Fung¹, Rachel Kenney³, Sara Hyman¹, Samarah Ahmed⁴, Azizi Seixas⁵, Girardin Jean-Louis⁶, Jennifer Frontera¹, Steven Galetta⁷, Laura Balcer⁸, Sujata ThAwani²
¹NYU Grossman School of Medicine, ²Neurology, NYU Grossman School of Medicine, ³Vanderbilt School of Medicine, ⁴New York University Grossman School of Medicine, ⁵University of Miami, ⁶University of Miami Miller School of Medicine, ⁷NYU Langone Medical Center, ⁸NYU School of Medicine

Objective:

We characterized the evolution of neurologic symptoms, and self-perceived recovery of non-hospitalized participants after an initial baseline evaluation for post-acute sequelae of COVID-19 (PASC).

Background:

Neurologic symptoms persist in some patients after COVID-19 infection.

Design/Methods:

In a follow-up study of a baseline cohort of SARS-CoV-2 laboratory-positive patients evaluated for PASC (November, 2020-August, 2021), 49.5% (46/93) participants completed follow-up phone questionnaires on their neurologic symptoms

Results:

Mean age after initial PASC assessment was 51.1 years (SD=16.5), 63% (29/46) were female and 95% received COVID-19 vaccination. Initial PASC assessment occurred at a median of 9.5 months (IQR=8.0–11.9) after COVID-19 infection. Median time between first visit and 1 year follow-up visit was 15.4 months (IQR=14.5-16.1). Median time between symptom onset and 1-year follow-up visit was 25.8 months (IQR=23.0-17.4).

The most frequent reported symptoms at follow-up included word finding difficulty (63%), change in memory (59%), anxiety (56%), fatigue (54%), and autonomic features of the eye (54%). Of the top 5 symptoms reported at first/baseline visit, fatigue, word finding difficulty, change in memory, and difficulty sleeping were not significantly different at 1-year follow-up, and shortness of breath decreased significantly (51 vs 30%, p=0.04, McNemer’s test). Autonomic eye symptoms increased significantly (31 vs 54%, p=0.03) whereas presence of headaches (44 vs 44%, p=1.00), reports of lightheadedness (48 vs 43%, p=1.00), palpitations (24 vs 33%, p=0.15), and anosmia did not change from baseline to follow-up (p=0.44), but anosmia improve from acute infection to 1 year follow-up (70 vs 35%, p=0.0006).

Conclusions:

Non-hospitalized neurology outpatients with PASC continue to experience, fatigue, word finding difficulty, change in memory and headaches. More participants at follow-up reported autonomic eye symptoms suggesting that screening for dysautonomia and vision-related symptoms may be important in this clinic-based population.