Younger, middle-aged adults face a higher burden of neurological long-COVID symptoms

Younger and middle adult patients are more affected by neurological symptoms of long COVID infection compared to older adults, according to recent research data published in the journal Annals of Neurology.¹ The study authors said the results support improved prevention, detection and treatment of long-COVID in patients who are disproportionately affected.

Younger, middle-aged adults face higher burden of neurological long-COVID symptoms / Fizkes – stock.adobe.com

An estimated 17 million adults in the United States have long COVID, a number that has remained relatively constant over the past year.² According to a KFF survey, 79% of adults with long COVID said it limited their activity either a lot or a little. And although 5 to 10% of adults in the country may continue to suffer from the disease at any given time, research to improve diagnosis and treatment continues to lag behind.

READ MORE: CBT and rehabilitation can improve symptoms of long COVID

“Symptoms attributable to (long COVID) are widespread and multisystemic, affecting the constitutional, respiratory, cardiovascular, musculoskeletal, neurological, psychiatric and gastrointestinal systems,” the authors write. “The neurological manifestations of (long COVID), also known as ‘neuro-(long COVID),’ can be particularly debilitating and contribute to a significant portion of the morbidity and disability faced by (long COVID) patients .”

Researchers at Northwestern University Feinberg School of Medicine conducted a study to characterize the neurological manifestations of long-COVID across the adult lifespan. The cross-sectional study examined patients treated at the Neuro-COVID-19 Clinic at Northwestern Memorial Hospital between May 2020 and March 2023. The aim of the study was to evaluate neurological symptoms, neurological examination results, quality of life and cognitive performance of the patients.

The study cohort included 1300 patients who tested positive for SARS-COV-2 and had persistent neurological symptoms lasting 6 weeks or longer since the COVID-19 outbreak. Of the patients, 200 had neuro-long COVID after hospitalization and 1,100 were not hospitalized with neuro-long COVID. Patients were admitted for evaluation if they had neurological symptoms consistent with SARS-CoV-2 infection. Patients were divided into three age groups: 18 to 44 years, 45 to 64 years, and 65 years or older.

The study found that middle-aged patients made up the majority of the post-hospitalization group and younger patients made up the majority of the non-hospitalization group. Overall, younger and middle-aged patients accounted for 71% of posthospitalized patients and 90.5% of nonhospitalized patients. Patients had a median of 5 neurologic manifestations or symptoms consistent with long COVID. In the post-hospitalization group, younger adults had a higher number of symptoms at 4 to 8, followed by middle-aged adults at 3 to 7 and older adults at 2 to 6. The number of symptoms was higher in patients in the no-hospitalization group not that significant.

Furthermore, higher burden of neurological symptoms resulted in poorer subjective quality of life in younger and middle-aged adults. Although older adults had the highest number of comorbidities and an increased frequency of abnormal neurological examinations, they had a lower burden of most neurological and non-neurological symptoms attributable to long COVID.

“While the number of deaths from COVID-19 continues to decline, people are still getting repeat infections with the virus and can develop long COVID over time,” said Dr. Igor Koralnik, corresponding author of the study, in a press release.³ “Long COVID leads to a change in the quality of life of patients. Despite vaccinations and boosters, about 30% of COVID patients develop some long COVID symptoms. These findings have enormous public health implications, as Long-COVID contributes significantly to the world’s largest burden of disability and disease caused by neurological disorders.”

READ MORE: COVID-19 Resource Center

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References

1. Choudhury NA, Mukherjee S, Singer T, et al. Neurological manifestations of long COVID disproportionately affect young and middle-aged adults. Ann Neurol. 2024. https://doi.org/10.1002/ana.27128

2. Burns A. How common is Long COVID at the end of isolation recommendations? Press release. KFF. April 9, 2024. Accessed December 3, 2024. https://www.kff.org/coronavirus-covid-19/issue-brief/as-recommendations-for-isolation-end-how-common-is-long- covid /

3. New research shows younger and middle-aged adults have worse long-term COVID symptoms than older adults. Press release. Northwestern Medicine. November 22, 2024. Accessed December 3, 2024. https://news.nm.org/new-research-shows-younger-and-middle-aged-adults-have-worse-long-covid-symptoms-than- older -adults/