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Publications

Journal Article Epublish

PubMed: 40761637 DOI: 10.3389/fneur.2025.1524613

Neurologic symptoms following COVID-19 in Lima, Peru: a prospective longitudinal observational study.

Front Neurol 16:1524613

Authors: Hanalise V Huff, Carla Villanueva-Colina, Monica M Diaz, Sofia Tovar, Andrea Davila Luna, Tianxia Wu, Davidson H Hamer, Igor J Koralnik, Tom Solomon, Miguela A Caniza, Patricia J Garcia

Affiliations

  • Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, United States.
  • Section of Infections of the Nervous System, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States.
  • School of Medicine, Cayetano Heredia University, Lima, Peru.
  • Department of Neurology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, United States.
  • Clinical Trials Unit, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States.
  • Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, United States.
  • Boston University Center on Emerging Infectious Diseases, Boston, MA, United States.
  • Ken and Ruth Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
  • The Pandemic Institute and The National Institute for Health and Care Research (NIHR) Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, United Kingdom.
  • The Walton Centre, NHS Foundation Trust, Liverpool, United Kingdom.
  • Department of Global Pediatric Medicine and Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, United States.
  • School of Public Health, Cayetano Heredia University, Lima, Peru.

Abstract

Introduction

There is limited research on long-term neurologic symptoms following SARS-CoV-2 infection in Peru. This study aimed to describe the longitudinal experience of survivors of mild to moderate COVID-19 in Lima, Peru.

Methods

This prospective, longitudinal observational study included neurologic follow-up data between 3- and 12-months following SARS-CoV-2 infection. Recruitment to a parent study: "Natural History of SARS-CoV-2 in Comparison to Influenza Virus: A Multi-site Study Focused on the Southern Hemisphere and Equatorial Regions" (COFLU Peru), occurred between February 2021 and February 2022 in a Callao, Peru public hospital emergency department. In-person visits for this sub-study, "Neuro COFLU," included neurologic history and symptom questionnaire.

Results

Fifty-four patients were seen for at least one visit, two of whom required hospitalization for COVID-19. Forty-one (76%) reported at least one pre-existing neurologic diagnosis (59% headaches; 24% migraines). At follow-up visits, patients reported at least one new neurologic symptom since COVID-19: 24/29 (83%) at 90 days, 31/42 (74%) at 180 days, 41/46 (89%) at 270 days, and 20/21 (95%) at 365 days. The median number of new symptoms was 3 at 90 days, 3 at 180, 4 at 270 and 3 at 365 days. Days 90-180 frequent symptoms included: muscular pain, neck stiffness, headache, loss of appetite, numbness, insomnia, and weakness (24-31%). Days 181-365 frequent symptoms included: fatigue, weakness, memory problems, irritability, changes in hearing, muscular pain, joint pain, and insomnia (28-33%). Pre-existing anxiety was associated with post-COVID-19 hearing changes, muscular pain, numbness and weakness and pre-existing depression with neck stiffness and numbness. No significant association was found with age, sex, vaccination status, or pre-existing headaches. Full recovery was reported for 6/29 (21%) at day 90, 13/42 (31%) at day 180, 17/46 (37%) at day 270, and 9/20 (45%) at day 365. By day 365, patients reported median recovery of 85-90%.

Discussion

Persistent neurological symptoms are common in COVID-19 survivors in Lima. Many new neurologic symptoms persisted and increased in prevalence over 3-12 months. Limitations include lack of control group and small sample size. Longitudinal studies of outcomes are needed to predict and mitigate the long-term physical, social and economic effects of SARS-CoV-2 infection.

MeSH

Headache, Global Health, Pain, Arthralgia, Recycling, Hearing, Hypesthesia, Signs And Symptoms, Covid-19, Sleep Initiation And Maintenance Disorders, Infections