Long Covid Symptoms

Kelsie Gonzalez got married last year. It was the perfect day despite the bride’s struggles with long Covid.

Objective To investigate neurologic manifestations of post-acute sequelae of SARS-CoV-2 infection (Neuro-PASC) in post-hospitalization Neuro-PASC (PNP) and non-hospitalized Neuro-PASC (NNP) patients...

Four in 10 Minnesotans who contracted COVID-19 reported in a new state survey that they struggled with lingering health problems like fatigue and brain fog for months after their illnesses. For some, the symptoms never went away. Everyday tasks such as getting dressed, going to work or simply concentrating were more difficult for this population, a...

Importance Management of long-term consequences after acute COVID-19 in people with multiple sclerosis and related disorders (pwMSRD) is challenging due to overlapping clinical presentations. There have been limited investigations of post-COVID sequelae in pwMSRD. Objective We assessed whether pwMSRD were more susceptible to post-COVID sequelae when compared to controls. Design This cross-sectional study leveraged a multi-center cohort of pwMSRD and controls. Setting A one-time web-based survey was conducted between August and December 2022. Participants Out of the 2,156 participants who consented, the analysis included 1,972 after excluding 184 due to missing data. Main Exposure Diagnosis of MSRD. Main Outcomes and Measures We surveyed 71 symptoms that emerged at least 1 month after the initial acute COVID-19 and were either new onset or worsening from the pre-COVID baseline. We assessed whether each participant experienced (1) ≥1 new symptom, (2) ≥1 worsening symptom from baseline. Results The study included 969 pwMSRD (799 [82.5%] women, mean age 51.8 [SD 12.1] years) and 1,003 controls (796 [79.4%] women, mean age 45.2 [SD 10.3] years). 613 pwMSRD (63.5%) and 614 controls (61.2%) experienced acute COVID-19. Compared to controls, pwMSRD had higher odds of developing a new symptom (OR=1.55; 95%CI=1.22-1.98; p.01) and experiencing a worsening symptom from baseline (OR=3.39; 95%CI=2.64-4.36; p.01). PwMSRD were more likely to develop new symptoms involving the pulmonary as well as head, eyes, ears, nose, and throat systems, and have worsening systemic, musculoskeletal, and neuropsychiatric symptoms from baseline. Acute COVID-19 severity mediated 20% of the association between MSRD diagnosis and post-COVID sequelae. In the subgroup of pwMS, having post-COVID sequelae was associated with worse functional disability. Conclusions and Relevance Compared to controls, pwMSRD experienced an increased risk of post-COVID sequelae involving multiple organ systems. Post-COVID sequelae was associated with greater disability in pwMS. The findings highlighted the importance of recognizing and managing long-term symptoms following acute COVID-19 in this vulnerable population. Key Points Question: Are people with multiple sclerosis and related disorders (pwMSRD) more susceptible to post-COVID sequelae? Findings: In this cross-sectional study that included 969 patients and 1,003 controls, pwMSRD had higher odds of experiencing post-COVID sequelae than controls after acute COVID-19. The association was mediated by the severity of acute COVID-19. Post-COVID symptoms, both new and worsening symptoms from baseline, were associated with worse neurological disability. Meaning: These findings highlight the importance of recognizing and effectively managing post-COVID sequelae in pwMSRD. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The study is supported in part by NINDS R01NS098023 and NINDS R01NS124882 ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee/IRB of University of Pittsburgh gave ethical approval for this work. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes De-identified data are available upon request to the corresponding author and with permission from the participating institutions. * aOR : adjusted odds ratio CNS : central nervous system CCI : Charlson comorbidity index DMT : disease-modifying therapy HEENT : head, eyes, ears, nose, and throat MOGAD : myelin oligodendrocyte glycoprotein antibody-associated disease MS : multiple sclerosis MSRD : multiple sclerosis and related disorders MSReCOV : Multiple Sclerosis Resilience to COVID-19 Collaborative MSRS-R : multiple sclerosis rating scale, revised NID : neuroimmunological disorders NMOSD : neuromyelitis optica spectrum disorder PDDS : patient determined disease steps PRO : patient-reported outcomes PROMIS : Patient-reported outcomes measurement information system pwMS : people with multiple sclerosis pwMSRD : people with multiple sclerosis and related disorders REDCap : Research Electronic Data Capture

Background Asthma, a chronic inflammatory airway disorder, can increase the risk of hospitalizations in individuals with viral infections such as COVID-19. The impact of the COVID-19 pandemic on asthma-related hospitalizations in the United States remains unknown. Objective We hypothesized that the COVID-19 pandemic led to an increase in economic burden to society and a decrease in hospitalization rates for asthma. Methods We analyzed weighted data from National Inpatient Sample (NIS) between January 1, 2018, and December 31, 2020. The outcomes were asthma hospitalization rates, length of stay (LOS), in-hospital mortality rates, and hospital admission costs. Results More people were admitted with a primary diagnosis of asthma in 2018 and 2019 compared to 2020 (hospitalization rate per 100,000: 2018: 38.6 versus (vs) 2019:37.0 vs 2020: 21.4; P

Background Long COVID (LC) is a complex, multi-organ syndrome that persists following recovery from the acute phase of coronavirus infection. Cardiovascular involvement is frequently reported in LC, often accompanied by a spectrum of related symptoms. Dysregulated lipid profiles and elevated atherogenic indices have been implicated in LC, yet no comprehensive systematic review and meta-analysis has specifically addressed these biomarkers. Objective This study aims to systematically evaluate atherogenic indices and lipid-related biomarkers in individuals with LC compared to healthy controls. Methods A systematic search was conducted in databases including PubMed, Google Scholar, SCOPUS, and SciFinder from September to November 2024. Eligible studies reported lipid biomarker data for LC patients and controls, yielding 44 studies encompassing 8,114 participants (3,353 LC patients and 4,761 controls). Results LC patients exhibited significant elevations in Castelli Risk Indexes 1 (standardized mean difference, SMD = 0.199; 95% confidence intervals, CI: 0.087–0.312) and 2 (SMD = 0.202; 95% CI: 0.087–0.318). Atherogenic ratios, including triglyceride (TG)/high-density lipoprotein (HDL) (SMD = 0.294; 95% CI: 0.155–0.433), (TG + low-density lipoprotein, LDL + very low-density lipoprotein, VLDL)/(HDL + apolipoprotein, ApoA) (SMD = 0.264; 95% CI: 0.145–0.383), and ApoB/ApoA (SMD = 0.515; 95% CI: 0.233–0.796), were also significantly elevated. Additionally, LC patients demonstrated increased levels of LDL, total cholesterol, triglycerides, and ApoB, alongside reduced HDL and ApoA levels. Results were free from publication bias. Conclusion LC is associated with a pro-atherogenic lipid profile, marked by increased atherogenic components and decreased protective lipid biomarkers. These findings highlight a potential heightened risk for cardiovascular complications in LC patients, warranting further clinical and mechanistic investigations. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The study was funded by FF66 grant and a Sompoch Endowment Fund (Faculty of Medicine), MDCU (RA66/016) to MM, and Grant № BGRRP2.0040007„01Strategic Research and Innovation Program for the Development of MU PLOVDIV (SRIPD MUP), Creation of a network of research higher schools, National plan forrecovery and sustainability, European Union NextGenerationEU. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The corresponding author (MM) will consider reasonable requests for access to the dataset (Excel file) utilized in this meta-analysis, following the completion of data usage by all contributing authors.

Introduction COVID-19 infection caused by SARS-CoV-2 has led to significant long-term health challenges, including Long COVID or Post-COVID condition, that can include symptoms such as cognitive decline, memory loss, and concentration issues. This study investigates the prevalence and risk factors of post-COVID cognitive symptoms among individuals tested for COVID-19. Methods A cross-sectional study was conducted in Lisbon and Tagus Valley, targeting individuals tested for COVID-19 in August 2022. Participants were selected from a random sample of 10,000 individuals. Data were collected via computer-assisted telephone interviews at 9 and 12 months post-test, covering sociodemographic details, health behaviors, pre-existing conditions, and COVID-19 symptoms. The primary outcome was the presence of at least one cognitive symptom (memory loss and/or concentration issues) at 9 and 12 months. Additionally, each symptom was assessed individually, along with a composite outcome of both symptoms concurrently. Results At 9 months, memory loss was reported by 24.87% of COVID-19 positive cases versus 10.20% of negatives, and concentration issues by 15.45% of positives versus 7.45% of negatives. At 12 months, memory loss prevalence was 16.67% for positives and 9.45% for negatives, while concentration issues were 9.82% for positives and 2.99% for negatives. Additionally, the prevalence of at least one cognitive symptom was 28.24% in positive cases at 9 months compared to 12.16% in negatives, and 17.81% versus 9.95% at 12 months. Female sex was significantly associated with a higher prevalence of cognitive symptoms at both time points. Discussion These findings underscore the enduring cognitive impact of COVID-19, with significant disparities in cognitive symptoms between COVID-19 positive and negative individuals observed at both 9 and 12 months post-infection. The higher prevalence of memory loss and concentration issues among COVID-19 positives suggests potential neurological sequelae linked to SARS-CoV-2 infection. Notably, the association of female sex with increased cognitive symptom prevalence warrants further investigation into gender-specific vulnerabilities or biological mechanisms underlying these disparities. Addressing these persistent cognitive symptoms is crucial for long-term patient management and underscores the need for targeted interventions and comprehensive post-COVID care strategies to mitigate long-lasting health implications. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Protocols ### Funding Statement Yes ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study involved human participants and was approved by the Ethics Committee for Health of the Regional Health Administration of Lisbon and Tagus Valley (2151/CES/2022) and the Data Protection Officer of the General Directorate of Health. Verbal informed consent was obtained from the participants prior to the questionnaire. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data cannot be shared publicly due to the confidentiality of participant information. However, researchers who meet the criteria for access to confidential data can request access by signing a declaration to carry out research projects using the LOCUS database. Requests should be directed to the project email (locus{at}ensp.unl.pt).

A substantial proportion of patients suffer from Post-COVID Syndrome (PCS) with fatigue and impairment of memory and concentration being the most important symptoms. We here set out to perform in-depth neuropsychological assessment of PCS patients referred to the Neurologic PCS clinic compared to pa …

In individuals with OSC/PCS, vaccination against SARS-CoV-2 improved symptom resolution; this effect was not observed, however, after other vaccinations.

The review indicates a significant burden of long-lasting symptoms within the workforce. The top five reported symptoms of Long Covid-19 were dyspnoea during mild and moderate activities, mental symptoms, fatigue and effort intolerance.

Long COVID has around 200 documented symptoms—and this could explain some of them.

Scientific Reports - Neurological post-COVID syndrome is associated with substantial impairment of verbal short-term and working memory

Among previously high-performing states, only Maryland suffered a bigger drop than we did.

Background The long-term sequelae of coronavirus disease 2019 (COVID-19) and its recovery have becoming significant public health concerns. Therefore, this study aimed to enhance the limited evidence regarding the relationship between sleep quality on long COVID among the older population aged 60 years or old. Methods Our study included 4,781 COVID-19 patients enrolled from April to May 2023, based on the Peking University Health Cohort. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) scale. Long COVID was evaluated by well-trained health professionals through patients’ self-reported symptoms. Binary logistic regression models were employed to calculate odds ratios (OR) and 95% confidence intervals (95% CI). Results The prevalence of long COVID among older adults was 57.4% (2,743/4,781). Specifically, the prevalence of general symptoms, cardiovascular symptoms, respiratory symptoms, gastrointestinal symptoms, and neurological and psychiatric symptoms was 47.7% (2,282/4,781), 3.4% (163/4,781), 35.2% (1683/4,781), 8.7% (416/4,781) and 5.8% (279/4,781), respectively. For each one-point increase in PSQI scores, the risk of long COVID, general symptoms, cardiovascular symptoms, gastrointestinal symptoms, and neurological and psychiatric symptoms increased by 3% (95% CI: 1.01, 1.06), 3% (95% CI: 1.01, 1.06), 7% (95% CI: 1.01, 1.13), 11% (95% CI: 1.07, 1.15), and 20% (95% CI: 1.15, 1.25), respectively. In multivariate models, compared with good sleepers, COVID-19 patients with poor sleep quality exhibited an increased risk of general symptoms (aOR = 1.17; 95% CI: 1.03, 1.33), cardiovascular symptoms (aOR = 1.50; 95% CI: 1.06, 2.14), gastrointestinal symptoms (aOR = 2.03; 95% CI: 1.61, 2.54), and neurological and psychiatric symptoms (aOR = 2.57; 95% CI = 1.96, 3.37). Conclusions Our findings indicate that poor sleep quality is related to various manifestations of long COVID in older populations. A comprehensive assessment and multidisciplinary management of sleep health and long COVID may be essential to ensure healthy aging in the future.

COVID-19 infection is not associated with immediate changes in multiple sclerosis (MS) symptom severity or disability, according to a study published online Dec. 23 in Neurology.

The UK Health Security Agency has warned people to be on the lookout for the signs as Covid cases continue to remain high in the UK, with other winter bugs such as RSV, flu and norovirus also circulating

ObjectiveThis study evaluated the association between acute COVID-19 cases and the number of car crashes with varying COVID-19 vaccination rates, Long COVID rates, and COVID-19 mitigation strategies.BackgroundThe ongoing SARS-CoV-2 pandemic has led to ...

Condition not common, but awareness is important as prompt treatment can reverse it Although uncommon, sudden permanent hearing loss seems to be linked to COVID-19 infection in some people, warn doctors, reporting the first UK case in the journal BMJ Case Reports. Awareness of this possible side effect is important, because a prompt course of steroid treatment

ts: Measurement devices vary significantly in their validity and reliability when compared with the gold standard of electrocardiogram (ECG). Wrist and hand devices typically demonstrate diminished validity for capturing HRV signal, while chest strap devices often exhibit high reliability and validity. Lack of transparency in third-party software used to clean and analyze HRV data makes assessment for accuracy problematic. This is of particular concern when single beat miscalculations can result in significantly dissimilar output. The conditions under which HRV data are collected, such as natural or paced breathing, activity intensity, and patient position, can dramatically affect HRV readings. While some individual HRV metrics have consistently been shown to reflect certain components of the ANS, such as high-frequency power as a measure of parasympathetic function, the meaning of other metrics is less clear. Recommendations for Clinical Practice: Heart rate variability can be an extraordinarily valuable tool to measure systemic function. However, it is recommended that clinicians be judicious in the interpretation of HRV, considering inconsistencies in presentation. This is particularly true in LC, where individual HRV varies greatly. In all populations, clinicians should consider using valid devices to assess trends in HRV values over time, along with consideration of unique physical conditions....

Long COVID causes bone pain and bone loss in 25% of cases by triggering inflammation and immune responses, especially in individuals with rheumatoid arthritis.

Background and objective Viral infections caused by cytomegalovirus, lymphocytic choriomeningitis virus, varicella-zoster virus, herpes simplex type 1 and type 2, rubella, measles, rubeola, HIV, West Nile virus, Lassa virus, and mumps are known to be associated with hearing loss. There have been reports of inner ear involvement in coronavirus disease 2019 (COVID-19) patients but the extent and variations in cochlear involvement of symptomatic and asymptomatic patients has not been adequately described. This study aimed to evaluate the hearing status among symptomatic and asymptomatic COVID-19 patients to address the prospects for routine screening for hearing loss in COVID-19 patients. Methods Patients testing positive for COVID-19 between March 2020 and May 2020 and August 2020 and October 2020 in Qatar were screened. A total of 110 patients aged 15-50 years were enrolled and grouped into symptomatic and asymptomatic COVID-19 after telephonic screening. Of them, seven were excluded for various reasons. A questionnaire was administered in person to all included participants. Audiological testing results of symptomatic and asymptomatic patients were analyzed. Results Of the 103 patients included in the study, 49 were symptomatic and 54 asymptomatic; 15 (14.6 %) had high-frequency sensorineural hearing loss (SNHL) in one or both ears. Mean thresholds in extended high frequencies 10K-20K were higher in symptomatic patients. Abnormal distortion product otoacoustic emissions (DPOAEs) were seen in 40 (38.8%) patients; 63.3% (31/49) were symptomatic and 16.7% (9/54) were asymptomatic in 3K-8K frequencies (p=0.0001).  Conclusions Symptomatic COVID-19 patients had significant involvement of the inner ears with abnormal pure tone audiometry (PTA), extended high-frequency audiometry (EHFA), and DPOAEs compared to asymptomatic COVID-19 patients. The extent of inner-ear involvement suggests the severity of the infection. The lack of audiovestibular symptoms does not rule out normal hearing in such patients. Screening for hearing loss should be routinely considered in post-COVID-19 patients.

🔥An intriguing large cohort study caught my attention, as both my second wife and her 21-year-old daughter experienced declines in GFR after COVID-19, with no recovery even after more than 12 months (→LC). “Findings of this… — Harry Spoelstra (@HarrySpoelstra)

Identifying the phenomenon of post-exertional malaise (PEM) in patients with fatiguing conditions is critical because it necessitates a far more cautious approa

Background Globally, the Coronavirus disease 2019 (COVID-19) pandemic had a significant impact on mental health. Sudden lifestyle changes, threatening information received through various sources, fear of infection and other stressors led to sleep disturbances such as insomnia. The current study aimed to assess the prevalence of insomnia and its associated risk factors during the first wave of COVID-19 pandemic among Singapore residents. Methods A cross-sectional study conducted online and in person, from May 2020 to June 2021, recruited Singapore citizens and permanent residents, aged 21 years and above, fluent in English, Chinese or Malay language. Respondents answered an interviewer-administered questionnaire, including Insomnia Severity Index (ISI), Generalised Anxiety Disorder-7 (GAD-7), Physical Health Questionnaire (PHQ-9), stress scale of the Depression, Anxiety and Stress Scales (DASS), chronic conditions checklist and COVID-19 related stressors (exposure to COVID-19, current and future perceived risk of infection). Chi-squared test followed by stepwise logistic regression analysis were conducted to determine factors associated with insomnia. Results The study recruited 1129 respondents. Prevalence of insomnia was noted to be 7.4% in the sample. Insomnia was significantly associated with psychological distress- depression (p

Background/Objectives: Internal tremor (IT) is often reported by patients with post-acute sequelae of SARS-CoV-2, also known as Long COVID, as a distressing and disabling symptom. Similarly, physicians are typically perplexed by the nature and etiology of IT and find it extremely challenging to manage. Methods: We describe a patient with Long COVID who experienced IT as part of post-COVID postural orthostatic tachycardia syndrome (POTS) and small fiber neuropathy (SFN) and review the limited literature available on this topic. Results: Our patient’s IT improved significantly after intravenous saline infusions, but there was no effect on IT with oral hydration, increased oral sodium chloride intake, neuropathic pain medications, muscle relaxants, or medications used for the treatment of POTS. Conclusions: Based on this case, our clinical experience, and the limited literature available to date, we believe IT is a manifestation of POTS and SFN, which may be driven by hypovolemia, cerebral hypoperfusion, sympathetic overactivity, neuropathic pain, and mast cell hyperactivation. Subjective description, objective findings, and diagnostic and therapeutic considerations in patients with IT and Long COVID are discussed.

New Index Presents Five Long COVID Symptom Types

It's not COVID or the flu. If you've been sick for a few weeks and have tested negative for everything, here's what's going on.

Background/Objectives: Female sex is one of the Long COVID (LC) risk factors; however, the LC predictors in females have not been established. This study was conducted to assess the influence of LC on the cardiovascular system and to assess the age-independent predictors of LC in females. Methods: Patient information and the course of the disease with symptoms were collected in women at least 12 weeks after COVID-19 recovery. The study participants were followed for 12 months. ECG monitoring, 24 h ECG monitoring, 24 h blood pressure monitoring, echocardiography, and biochemical tests were performed. Results: We studied 1946 consecutive female patients (age 53.0 [43.0–63.0] vs. 52.5 [41.0–63.0], p = 0.25). A more frequent occurrence of LC was observed in females with a severe SARS-CoV-2 infection (p = 0.0001). Women with LC compared to the control group had higher body mass index (p = 0.001), lower level of HDL cholesterol (p = 0.015), higher level of TG (p 0.001) and higher TG/HDL ratio (p 0.001), more often myocardial damage (p 0.001), and lower LVEF (p = 0.01). LC women had more often QRS fragmentation, longer QTcB, and one of the ECG abnormalities. In a multivariate analysis in younger females with BMI 24.8 kg/m2, TG/HDL ratio 1.89 and severe course of COVID-19 and in older females, TG/HDL ratio 1.89, lower LVEF, and also severe course of infection were independent LC predictors. Conclusions: Independent predictors of LC occurrence in women, regardless of age, are severe course of COVID-19 and TG/HDL ratio 1.89. The presence of comorbidities and lifestyle before COVID-19 had no impact on the occurrence of LC in females regardless of age.