{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:23:06Z","timestamp":1792131786450,"version":"4.4.0"},"reference-count":70,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T00:00:00Z","timestamp":1617062400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ann Clin Transl Neurol"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Most SARS\u2010CoV\u20102\u2010infected individuals never require hospitalization. However, some develop prolonged symptoms. We sought to characterize the spectrum of neurologic manifestations in non\u2010hospitalized Covid\u201019 \u201clong haulers\u201d.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a prospective study of the first 100 consecutive patients (50 SARS\u2010CoV\u20102 laboratory\u2010positive (SARS\u2010CoV\u20102<jats:sup>+<\/jats:sup>) and 50 laboratory\u2010negative (SARS\u2010CoV\u20102<jats:sup>\u2010<\/jats:sup>) individuals) presenting to our Neuro\u2010Covid\u201019 clinic between May and November 2020. Due to early pandemic testing limitations, patients were included if they met Infectious Diseases Society of America symptoms of Covid\u201019, were never hospitalized for pneumonia or hypoxemia, and had neurologic symptoms lasting over 6\u00a0weeks. We recorded the frequency of neurologic symptoms and analyzed patient\u2010reported quality of life measures and standardized cognitive assessments.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Mean age was 43.2\u00a0\u00b1\u00a011.3\u00a0years, 70% were female, and 48% were evaluated in televisits. The most frequent comorbidities were depression\/anxiety (42%) and autoimmune disease (16%). The main neurologic manifestations were: \u201cbrain fog\u201d (81%), headache (68%), numbness\/tingling (60%), dysgeusia (59%), anosmia (55%), and myalgias (55%), with only anosmia being more frequent in SARS\u2010CoV\u20102<jats:sup>+<\/jats:sup> than SARS\u2010CoV\u20102<jats:sup>\u2010<\/jats:sup> patients (37\/50 [74%] vs. 18\/50 [36%]; <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.001). Moreover, 85% also experienced fatigue. There was no correlation between time from disease onset and subjective impression of recovery. Both groups exhibited impaired quality of life in cognitive and fatigue domains. SARS\u2010CoV\u20102<jats:sup>+<\/jats:sup> patients performed worse in attention and working memory cognitive tasks compared to a demographic\u2010matched US population (T\u2010score 41.5 [37, 48.25] and 43 [37.5, 48.75], respectively; both <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Non\u2010hospitalized Covid\u201019 \u201clong haulers\u201d experience prominent and persistent \u201cbrain fog\u201d and fatigue that affect their cognition and quality of life.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51350","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T10:51:11Z","timestamp":1616496671000},"page":"1073-1085","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":635,"title":["Persistent neurologic symptoms and cognitive dysfunction in non\u2010hospitalized Covid\u201019 \u201clong haulers\u201d"],"prefix":"10.1002","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6862-5531","authenticated-orcid":false,"given":"Edith L.","family":"Graham","sequence":"first","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1214-3645","authenticated-orcid":false,"given":"Jeffrey R.","family":"Clark","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary S.","family":"Orban","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick H.","family":"Lim","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"April L.","family":"Szymanski","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Taylor","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca M.","family":"DiBiase","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan Tong","family":"Jia","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roumen","family":"Balabanov","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam U.","family":"Ho","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayush","family":"Batra","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric M.","family":"Liotta","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6836-1468","authenticated-orcid":false,"given":"Igor J.","family":"Koralnik","sequence":"additional","affiliation":[{"name":"Davee Department of Neurology Northwestern University Feinberg School of Medicine Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,30]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"COVID\u201019 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University and Medicine","year":"2021"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30221-0"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25807"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.12603"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2020.1127"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000009937"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/acn3.51210"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-020-06001-y"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32662-3"},{"key":"e_1_2_7_11_1","volume-title":"NIH announces research opportunities to study \u201cLong COVID\u201d","year":"2021"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s42399-020-00453-3"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.2648"},{"key":"e_1_2_7_14_1","article-title":"How and why patients made Long Covid","volume":"1","author":"Callard F","year":"2020","journal-title":"Soc Sci Med."},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1183\/23120541.00542-2020"},{"key":"e_1_2_7_16_1","article-title":"Antibody tests for identification of current and past infection with SARS\u2010CoV\u20102","volume":"6","author":"Deeks JJ","year":"2020","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2516"},{"key":"e_1_2_7_18_1","article-title":"Longitudinal analysis of serology and neutralizing antibody levels in COVID19 convalescents","author":"Muecksch F","year":"2020","journal-title":"J Infect Dis"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychires.2020.06.022"},{"key":"e_1_2_7_20_1","volume-title":"Beating Covid, only to be left with brain fog: [Foreign Desk]","author":"Belluck P","year":"2020"},{"key":"e_1_2_7_21_1","volume-title":"First travel\u2010related case of 2019 novel coronavirus detected in United States","year":"2020"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa760"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2010.08.033"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3522"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182872e5f"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617714000241"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182872ded"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617714000320"},{"key":"e_1_2_7_29_1","article-title":"Attributes and predictors of Long\u2010COVID: analysis of COVID cases and their symptoms collected by the Covid Symptoms Study App","author":"Sudre CH","year":"2020","journal-title":"medRxiv"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m3026"},{"key":"e_1_2_7_31_1","volume-title":"COVID\u201019 rapid guideline: managing the long\u2010term effects of COVID\u201019","year":"2020"},{"key":"e_1_2_7_32_1","first-page":"1","article-title":"SARS\u2010CoV\u20102, SARS\u2010CoV, and MERS\u2010CoV viral load dynamics, duration of viral shedding, and infectiousness: a systematic review and meta\u2010analysis","author":"Cevik M","year":"2020","journal-title":"Lancet Microbe"},{"key":"e_1_2_7_33_1","volume-title":"SARS\u2010CoV\u20102 IgG Architect \u2010 Instructions for Use","author":"Abbott Laboratories","year":"2020"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/cti2.1189"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9103188"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc2025179"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-020-0965-6"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-020-00813-8"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI138759"},{"key":"e_1_2_7_40_1","article-title":"Declining prevalence of antibody positivity to SARS\u2010CoV\u20102: a community study of 365,000 adults","author":"Ward H","year":"2020","journal-title":"medRxiv"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2020.104544"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1086\/511038"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23893"},{"key":"e_1_2_7_44_1","unstructured":"Research opportunity announcement OTA\u201021\u2010015B post\u2010acute sequelae of SARS\u2010CoV\u20102 infection initiative: SARS\u2010CoV\u20102 recovery cohort studies;2021; Available from:https:\/\/covid19.nih.gov\/sites\/default\/files\/2021\u201002\/PASC\u2010ROA\u2010OTA\u2010Recovery\u2010Cohort\u2010Studies.pdf."},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100041664"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.27425"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.22641"},{"key":"e_1_2_7_48_1","volume-title":"Progress in Autoimmune Diseases Research","author":"The Autoimmune Diseases Coordinating Committee","year":"2005"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780400909"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2002032"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.3109\/14397595.2013.854059"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m1966"},{"key":"e_1_2_7_53_1","volume-title":"NCS\u2010R Lifetime prevalence estimates (Table 1. Lifetime prevalence of DSM\u2010IV\/WMH\u2010CIDI disorders by sex and cohort)","year":"2005"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.19686"},{"key":"e_1_2_7_55_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.0225"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105542"},{"key":"e_1_2_7_57_1","volume-title":"PROMIS\u00ae Score Cut Points","author":"HealthMeasures","year":"2020"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1080\/21641846.2020.1778227"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0240784"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.160.2.221"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.3109\/02699052.2010.531687"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1038\/d41586-020-02598-6"},{"key":"e_1_2_7_63_1","article-title":"COVID\u201019 can last for several months","author":"Yong E","year":"2020","journal-title":"The Atlantic"},{"key":"e_1_2_7_64_1","volume-title":"Paul Garner: For 7 weeks I have been through a roller coaster of ill health, extreme emotions, and utter exhaustion","author":"Garner P","year":"2020"},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.17709"},{"key":"e_1_2_7_66_1","doi-asserted-by":"publisher","DOI":"10.1177\/104973230201200202"},{"key":"e_1_2_7_67_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3182872ea0"},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.0830"},{"key":"e_1_2_7_69_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410140404"},{"key":"e_1_2_7_70_1","volume-title":"One in 20 people likely to suffer from \u2018Long COVID\u2019, but who are they?","author":"COVID Symptom Study","year":"2020"},{"key":"e_1_2_7_71_1","first-page":"1","article-title":"Long COVID in the Faroe Islands \u2010 a longitudinal study among non\u2010hospitalized patients","author":"Petersen MS","year":"2020","journal-title":"Clin Infect Dis"}],"container-title":["Annals of Clinical and Translational Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acn3.51350","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/acn3.51350","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acn3.51350","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,1]],"date-time":"2023-09-01T08:55:31Z","timestamp":1693558531000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/acn3.51350"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,30]]},"references-count":70,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1002\/acn3.51350"],"URL":"https:\/\/doi.org\/10.1002\/acn3.51350","archive":["Portico"],"relation":{},"ISSN":["2328-9503","2328-9503"],"issn-type":[{"value":"2328-9503","type":"print"},{"value":"2328-9503","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,30]]},"assertion":[{"value":"2021-02-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-30","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}