Outcome predictors of post-COVID conditions in the European Academy of Neurology COVID-19 registry.

Several neurological manifestations are part of the post-COVID condition. We aimed to: (1) evaluate the 6-month outcome in the cohort of patients with neurological manifestations during the COVID-19 acute phase and surviving the infection, and find outcome predictors; (2) define the prevalence and type of neurological symptoms persistent at six months after the infection. Data source was an international registry of patients with COVID-19 infection and neurological symptoms, signs or diagnoses established by the European Academy of Neurology. Functional status at six-month follow-up was measured with the modified Rankin scale (mRS), and defined as: "stable/improved" if the mRS at six months was equal as or lower than the baseline score; "worse" if it was higher than the baseline score. By October 30, 2022, 1,003 lab-confirmed COVID-19 patients were followed up for a median of 6.5 months. Compared to their pre-morbid status, 522 patients (52%) were stable/improved, whereas 465 (46%) were worse (functional status missing for 16). Age, hospitalization, several pre-COVID-19 comorbidities, and COVID-19 general complications were predictors of a worse status. Amongst neurological manifestations, stroke carried the highest risk for worse outcome (OR 5.96), followed by hyperactive delirium (2.8), and peripheral neuropathies (2.37). On the other hand, hyposmia/hypogeusia (0.38), headache (0.40), myalgia (0.45), and COVID-19 vaccination (0.52) were predictors of a favourable prognosis. Persisting neurological symptoms or signs were reported by 316/1003 patients (31.5%), the commonest being fatigue (n = 133), and impaired memory or concentration (n = 103). Our study identified significant long-term prognostic predictors in patients with COVID-19 and neurological manifestations.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: First Described Complication after Gam-COVID-Vac Vaccine.

BACKGROUND: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a severe, debilitating chronic disease characterized by marked tiredness and fatigue, cognitive dysfunction, sleep disturbances, pain, and autonomic, immunological, and metabolic dysfunctions, in which all symptoms are usually exacerbated by physical and/or psychological stress. SUBJECTS AND METHODS: We report a case of ME/CFS with severe myalgia and severe locomotor disorders in a 25-year-old female after Gam-COVID-Vac vaccine (Sputnik V) ten days before the manifestation of the symptoms. RESULTS: This is the first report of such a complication from the Gam-COVID-Vac vaccine.

Clinical Features in Russian Patients with COVID-Associated Parosmia/Phanthosmia.

BACKGROUND: Olfactory dysfunction is a typical symptom of COVID-19 infection. While COVID-associated anosmia is well-described, knowledge of parosmia (olfactory distortions) and phanthosmia (olfactory hallucinations) is relatively lacking. We undertook a clinical study of the parosmia/phanthosmia phenotype, aiming to support improved prediction and management of these symptoms. SUBJECTS AND METHODS: In a cross-sectional study between September 2020 and May 2021, we recruited 187 COVID-19 patients with parosmia/phanthosmia via social media and a matched healthy control group from neurologists. The patients received an online video-consultation with a neurologist trained in olfactory research and completed a questionnaire to assess the nature of their subjective olfactory disorder. RESULTS: In the acute period of COVID-19 parosmia/phanthosmia, patients often experienced comorbid manifestations such as fatigue, fever, headache, myalgia, and "brain fog". Isolated phanthosmia was observed in 13.9% of acute COVID-19 patients, as compared to 34.2% in the long term. Parosmia was described in 89.8% of patients in the long-term course of the disease. COVID-associated parosmia/phanthosmia was more common in women (81.3%) than men (18.7%). Almost all parosmia/phanthosmia patients had an acute history of anosmia, which often progressed to hyposmia. A third of the patients had a history of taste disturbance The long-term COVID-19 sequelae such as fatigue, brain fog, and dizziness are significantly more common among patients with parosmia/phanthosmia, as were autonomic symptoms such as awareness of heartbeat and rapid pulse. The incidence of migraine with aura was significantly higher in the parosmia/phanthosmia group than in the control group (8% versus 0.9%). The allergy was reported significantly more frequent in the study group compared to the control group. CONCLUSIONS: Qualitative olfactory disorders occur frequently in COVID-19 patients. Those with the parosmia/phanthosmia phenotype have a higher risk for other symptoms, notably headache (including migraine with aura), fatigue, brain fog, dizziness, and cardiovascular/autonomic manifestations, as well as allergy. We suppose that further investigation of this phenomenon will reveal phenotypic variants depending on particular symptoms cluster; improved nosology of qualitative olfactory disorders in COIVD-19 is a prerequisite for establishing appropriate treatments.

Association between COVID-19 and catatonia manifestation in two adolescents in Central Asia: Incidental findings or cause for alarm?

Catatonia is a rare neuropsychiatric syndrome that can accompany various medical conditions, including schizophrenia, autoimmune encephalitis, and infectious diseases. We present two cases of catatonia in males aged 12 and 17 years from Central Asia who tested positive for SARS-Cov-2 antibodies. Detailed medical assessments declined other potential precipitating factors, including schizophrenia or anti-NMDA receptor autoimmune encephalitis. FDG-PET in the younger patient demonstrated focal hypometabolism in left frontotemporal and right associative visual cortex, matching patterns previously seen in adults with catatonia. These isolated findings raise concerns about a possible causal relationship between COVID-19 infection and risk of catatonia manifestation in adolescents.