Younger patients more affected by neurologic manifestations of long COVID

Younger and middle-aged patients seem to be disproportionately affected by neurologic manifestations of postacute sequelae of severe acute respiratory syndrome coronavirus 2 infection (Neuro-PASC), according to a study published online Nov. 22 in the Annals of Neurology.

Natasha A. Choudhury, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues conducted a cross-sectional study of the first consecutive 200 posthospitalization Neuro-PASC and 1,100 nonhospitalized Neuro-PASC (NNP) patients assessed at a Neuro-COVID-19 clinic between May 2020 and March 2023. Patients were divided into age groups: younger, middle-aged, and older (18 to 44, 45 to 64, and 65-plus years, respectively).

The researchers found that significant age-related differences in the frequencies of comorbidities and abnormal neurologic findings demonstrated higher prevalence in older patients. Conversely, significant age-related differences in Neuro-PASC symptoms, indicating lower prevalence and symptom burden in older individuals, were seen at 10 months from COVID-19 onset.

In the NNP group, there were significant age-related differences observed in subjective impression of fatigue and sleep disturbance, corresponding with higher impairment in quality of life for younger patients. In NNP patients, significant age-related differences were seen in objective executive function and working memory, with the worst performance seen in younger patients.

“The impact of this condition causing disproportionate morbidity and disability in younger adults in their prime, who provide much of the workforce, productivity, and innovation in our society, may lead to critical issues of increased health care system burden, mental health crisis, socio-cultural deterioration, and economic recession,” the authors write.

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