Clinical Phenotyping of Long COVID Patients Evaluated in a Specialized Neuro‐COVID Clinic

ABSTRACT Objective To report Long COVID characteristics and longitudinal courses of patients evaluated between 4/14/21–4/14/22 at the University of Pennsylvania Neurological COVID Clinic (PNCC), including clinical symptoms, neurological examination findings, and neurocognitive screening tests from a...

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Main Authors: Luana D. Yamashita, Neel Desai, Abigail R. Manning, Caitlin Pileggi, Sara Manning Peskin, Danielle K. Sandsmark, Dennis L. Kolson, Matthew K. Schindler
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Annals of Clinical and Translational Neurology
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Online Access:https://doi.org/10.1002/acn3.70031
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author Luana D. Yamashita
Neel Desai
Abigail R. Manning
Caitlin Pileggi
Sara Manning Peskin
Danielle K. Sandsmark
Dennis L. Kolson
Matthew K. Schindler
author_facet Luana D. Yamashita
Neel Desai
Abigail R. Manning
Caitlin Pileggi
Sara Manning Peskin
Danielle K. Sandsmark
Dennis L. Kolson
Matthew K. Schindler
author_sort Luana D. Yamashita
collection DOAJ
description ABSTRACT Objective To report Long COVID characteristics and longitudinal courses of patients evaluated between 4/14/21–4/14/22 at the University of Pennsylvania Neurological COVID Clinic (PNCC), including clinical symptoms, neurological examination findings, and neurocognitive screening tests from a standardized PNCC neurological evaluation approach. Methods This is a retrospective cross‐sectional and longitudinal study in a single‐center tertiary care academic center. Participants include 240 patients with documented evidence of a positive SARS‐CoV‐2 PCR or antibody test who underwent initial evaluation and 182 patients with longitudinal follow‐up. Main outcomes evaluated are patient demographics, duration of illness prior to self‐reported improvement, and cognitive testing results—including the Montreal Cognitive Assessment (version 8.2) (MoCA) and Oral Trail Making Test‐B (OTMT‐B). Results The majority (73%) of patients did not require hospitalization for their acute COVID‐19 symptoms. Frequent Long COVID complaints included headache (60%), dizziness/vertigo (40%), and disturbance of taste/smell (40%). Almost all (94%) patients reported cognitive symptoms, and over 30% of patients had abnormal scores on cognitive testing. Severe infection, fewer years of education level, and non‐White race were found to be statistically associated with an increased likelihood of having abnormal scores on cognitive testing. Neuroimaging and clinical laboratory testing were largely not informative for patient care. Sixty‐two percent of patients with follow‐up visits self‐reported improvement in their primary neurological complaint within 1 year of evaluation. Interpretation Performance on standardized cognitive screening tests may not be consistent with frequently reported cognitive complaints in Long COVID patients. The most common clinical trajectory was self‐reported improvement in the primary neurological symptom.
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spelling doaj-art-5cdaffb2d2884fee8d71d15d4a81b51e2025-08-20T02:07:09ZengWileyAnnals of Clinical and Translational Neurology2328-95032025-06-011261126113410.1002/acn3.70031Clinical Phenotyping of Long COVID Patients Evaluated in a Specialized Neuro‐COVID ClinicLuana D. Yamashita0Neel Desai1Abigail R. Manning2Caitlin Pileggi3Sara Manning Peskin4Danielle K. Sandsmark5Dennis L. Kolson6Matthew K. Schindler7Department of Neurology University of Pennsylvania Philadelphia Pennsylvania USADepartment of Biostatistics, Epidemiology, and Informatics University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USADepartment of Neurology University of Pennsylvania Philadelphia Pennsylvania USAABSTRACT Objective To report Long COVID characteristics and longitudinal courses of patients evaluated between 4/14/21–4/14/22 at the University of Pennsylvania Neurological COVID Clinic (PNCC), including clinical symptoms, neurological examination findings, and neurocognitive screening tests from a standardized PNCC neurological evaluation approach. Methods This is a retrospective cross‐sectional and longitudinal study in a single‐center tertiary care academic center. Participants include 240 patients with documented evidence of a positive SARS‐CoV‐2 PCR or antibody test who underwent initial evaluation and 182 patients with longitudinal follow‐up. Main outcomes evaluated are patient demographics, duration of illness prior to self‐reported improvement, and cognitive testing results—including the Montreal Cognitive Assessment (version 8.2) (MoCA) and Oral Trail Making Test‐B (OTMT‐B). Results The majority (73%) of patients did not require hospitalization for their acute COVID‐19 symptoms. Frequent Long COVID complaints included headache (60%), dizziness/vertigo (40%), and disturbance of taste/smell (40%). Almost all (94%) patients reported cognitive symptoms, and over 30% of patients had abnormal scores on cognitive testing. Severe infection, fewer years of education level, and non‐White race were found to be statistically associated with an increased likelihood of having abnormal scores on cognitive testing. Neuroimaging and clinical laboratory testing were largely not informative for patient care. Sixty‐two percent of patients with follow‐up visits self‐reported improvement in their primary neurological complaint within 1 year of evaluation. Interpretation Performance on standardized cognitive screening tests may not be consistent with frequently reported cognitive complaints in Long COVID patients. The most common clinical trajectory was self‐reported improvement in the primary neurological symptom.https://doi.org/10.1002/acn3.70031brain fogcognitivelong COVIDMoCApost‐COVID
spellingShingle Luana D. Yamashita
Neel Desai
Abigail R. Manning
Caitlin Pileggi
Sara Manning Peskin
Danielle K. Sandsmark
Dennis L. Kolson
Matthew K. Schindler
Clinical Phenotyping of Long COVID Patients Evaluated in a Specialized Neuro‐COVID Clinic
Annals of Clinical and Translational Neurology
brain fog
cognitive
long COVID
MoCA
post‐COVID
title Clinical Phenotyping of Long COVID Patients Evaluated in a Specialized Neuro‐COVID Clinic
title_full Clinical Phenotyping of Long COVID Patients Evaluated in a Specialized Neuro‐COVID Clinic
title_fullStr Clinical Phenotyping of Long COVID Patients Evaluated in a Specialized Neuro‐COVID Clinic
title_full_unstemmed Clinical Phenotyping of Long COVID Patients Evaluated in a Specialized Neuro‐COVID Clinic
title_short Clinical Phenotyping of Long COVID Patients Evaluated in a Specialized Neuro‐COVID Clinic
title_sort clinical phenotyping of long covid patients evaluated in a specialized neuro covid clinic
topic brain fog
cognitive
long COVID
MoCA
post‐COVID
url https://doi.org/10.1002/acn3.70031
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