One year follow-up of neurologic symptoms in non-hospitalized neurology outpatients with post-acute sequelae of COVID-19 (PASC)
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

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).

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

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).



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.