Customized treatment needed for long COVID

A new study published in the Annals of Neurology has shed light on the lingering symptoms of long COVID. The study analyzed the first 600 long COVID patients evaluated at the Northwestern Medicine Neuro COVID-19 Clinic between May 2020 and August 2021. Patients were seen about 7 months after the start of their COVID illness, and only about 60% of patients regarded themselves as “recovered” from their illness.

Both groups of patients, those who had been hospitalized for acute COVID-19 pneumonia and those who had milder forms of the disease, showed an average of seven neurological symptoms, while more than nine out of 10 said they had more than four symptoms.

The study found that COVID affects the nervous system and causes severe decrease in quality of life and cognitive dysfunction in patients. Symptoms included brain fog, headaches, loss of smell, altered sense of taste, dizziness, muscle pain, numbness/tingling, pain other than in the chest, ringing or other noises in the ear, and blurred vision.

Despite common symptoms that former hospitalized and non-hospitalized long COVID patients share, the researchers found notable differences between the groups. For example, hospitalized patients had more abnormal neurologic exams compared to non-hospitalized patients and did worse on processing speed, attention, and working memory tasks. By contrast, non-hospitalized patients had lower results in attention tasks only.

The study concluded that there is no one-size-fits-all treatment for long COVID and many different patients are having many different symptoms. The researchers recommended treating long COVID patients with precision medicine, based on their specific symptoms and needs.

Long COVID patients continue to face day-to-day challenges, including fatigue, depression/anxiety, insomnia, shortness of breath, variations of heart rate and blood pressure issues, chest pain, and gastrointestinal symptoms, such as nausea, vomiting, or diarrhea. All of the patients showed significantly impaired quality of life in areas of cognition, fatigue, sleep, anxiety, and depression, compared to the rest of the U.S. population.

The study’s senior author, Igor Koralnik, MD, chief of neuroinfectious diseases and global neurology at Northwestern Medicine in Chicago, believes that we need to pay attention to the similarities and differences in patients with long COVID and recommends treating them with precision medicine, based on their specific symptoms and needs.


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