Neurological outcomes 1 year after COVID-19 diagnosis: A prospective longitudinal cohort study

Verena Rass; Ronny Beer; Alois Josef Schiefecker; Anna Lindner; Mario Kofler; Bogdan Andrei Ianosi; Philipp Mahlknecht; Beatrice Heim; Marina Peball; Federico Carbone; Victoria Limmert; Philipp Kindl; Lauma Putnina; Elena Fava; Sabina Sahanic; Thomas Sonnweber; Wolfgang N Löscher; Julia V Wanschitz; Laura Zamarian; Atbin Djamshidian; Ivan Tancevski; Günter Weiss; Rosa Bellmann-Weiler; Stefan Kiechl; Klaus Seppi; Judith Loeffler-Ragg; Bettina Pfausler; Raimund Helbok

doi:10.1111/ene.15307

Neurological outcomes 1 year after COVID-19 diagnosis: A prospective longitudinal cohort study

Eur J Neurol. 2022 Jun;29(6):1685-1696. doi: 10.1111/ene.15307. Epub 2022 Mar 23.

Authors

Verena Rass¹, Ronny Beer¹, Alois Josef Schiefecker¹, Anna Lindner¹, Mario Kofler¹, Bogdan Andrei Ianosi¹, Philipp Mahlknecht¹, Beatrice Heim¹, Marina Peball¹, Federico Carbone¹, Victoria Limmert¹, Philipp Kindl¹, Lauma Putnina¹, Elena Fava¹, Sabina Sahanic², Thomas Sonnweber², Wolfgang N Löscher¹, Julia V Wanschitz¹, Laura Zamarian¹, Atbin Djamshidian¹, Ivan Tancevski², Günter Weiss², Rosa Bellmann-Weiler², Stefan Kiechl¹, Klaus Seppi¹, Judith Loeffler-Ragg², Bettina Pfausler¹, Raimund Helbok¹

Affiliations

¹ Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
² Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.

Abstract

Background and purpose: Neurological sequelae from coronavirus disease 2019 (COVID-19) may persist after recovery from acute infection. Here, the aim was to describe the natural history of neurological manifestations over 1 year after COVID-19.

Methods: A prospective, multicentre, longitudinal cohort study in COVID-19 survivors was performed. At a 3-month and 1-year follow-up, patients were assessed for neurological impairments by a neurological examination and a standardized test battery including the assessment of hyposmia (16-item Sniffin' Sticks test), cognitive deficits (Montreal Cognitive Assessment < 26) and mental health (Hospital Anxiety and Depression Scale and Post-traumatic Stress Disorder Checklist 5).

Results: Eighty-one patients were evaluated 1 year after COVID-19, out of which 76 (94%) patients completed a 3-month and 1-year follow-up. Patients were 54 (47-64) years old and 59% were male. New and persistent neurological disorders were found in 15% (3 months) and 12% (10/81; 1 year). Symptoms at 1-year follow-up were reported by 48/81 (59%) patients, including fatigue (38%), concentration difficulties (25%), forgetfulness (25%), sleep disturbances (22%), myalgia (17%), limb weakness (17%), headache (16%), impaired sensation (16%) and hyposmia (15%). Neurological examination revealed findings in 52/81 (64%) patients without improvement over time (3 months, 61%, p = 0.230) including objective hyposmia (Sniffin' Sticks test <13; 51%). Cognitive deficits were apparent in 18%, whereas signs of depression, anxiety and post-traumatic stress disorders were found in 6%, 29% and 10% respectively 1 year after infection. These mental and cognitive disorders had not improved after the 3-month follow-up (all p > 0.05).

Conclusion: Our data indicate that a significant patient number still suffer from neurological sequelae including neuropsychiatric symptoms 1 year after COVID-19 calling for interdisciplinary management of these patients.

Keywords: COVID-19; SARS-CoV-2; long COVID; neurological manifestations.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anosmia / diagnosis
Anosmia / etiology
COVID-19* / complications
COVID-19* / diagnosis
Cohort Studies
Female
Humans
Longitudinal Studies
Male
Middle Aged
Prospective Studies
SARS-CoV-2