Long COVID can cause psychological symptoms including mood disorders, fatigue and perceived cognitive impairment that can impact on returning to work and resuming normal activities, new research has revealed.
A new study reports on the first 100 patients to participate in Mayo Clinic’s COVID-19 Activity Rehabilitation program (CARP), one of the first multidisciplinary programmes established to evaluate and treat patients with post-COVID-19 syndrome, also known as Long COVID.
More than a third of patients reported difficulties performing basic activities of daily living, and only one in three patients had returned to unrestricted work activity.
Most had no pre-existing health conditions and did not experience a severe case of COVID-19.
The most common symptom was fatigue, Mayo Clinic found, with 80 per cent of people reporting unusual levels of extreme tiredness. Additionally, 59 per cent reported respiratory complaints and a similar percentage had neurologic issues, such as ‘brain fog’.
“Most patients in the study had no pre-existing comorbidities prior to COVID-19 infection, and many did not experience symptoms related to COVID-19 that were severe enough to require hospitalisation,” says Greg Vanichkachorn, medical director of Mayo Clinic’s COVID-19 Activity Rehabilitation programme and first author of the study.
“Most of the patients had normal or non-diagnostic lab and imaging results, despite having debilitating symptoms. That’s among the challenges of diagnosing PCS in a timely way and then responding effectively.”
However, the symptoms often resulted in significant negative effects as patients tried to return to normal daily activities, including work.
“Most patients with whom we worked required physical therapy, occupational therapy or brain rehabilitation to address the perceived cognitive impairment,” says Dr. Vanichkachorn.
“While many patients had fatigue, more than half also reported troubles with thinking, commonly known as ‘brain fog.’ And more than one third of patients had trouble with basic activities of life. Many could not resume their normal work life for at least several months.”
The patients were evaluated and treated between June 1 and December 31, 2020. They had a mean age of 45, and 68 per cent were female. They were evaluated a mean of 93 days after infection.
Mayo Clinic developed the COVID-19 Activity Rehabilitation program at Mayo Clinic in Rochester in the US in June 2020, to care for patients experiencing persistent symptoms after COVID-19 infection.
In addition to Dr Vanichkachorn, Mayo Clinic staff from many specialty fields are involved in diagnostics and treatment. Among services provided are psychosocial support for patients who frequently report feelings of abandonment, guilt and frustration during initial evaluation.
Mayo Clinic is conducting intensive research on post-COVID-19 syndrome, in part to better define how the condition presents across different socioeconomic groups and ethnicities. Prolonged symptoms, such as those experienced with post-COVID-19 syndrome, have been reported in prior epidemics.
“As the pandemic continues, we expect to see more patients who experience symptoms long after infection, and health care providers need to prepare for this, know what to look for, and know how to best provide for their patients’ needs,” says Dr. Vanichkachorn.
