Post-acute sequelae of SARS-CoV-2 mimic: An important neurological condition

Area of Science:

• Neurology
• Infectious Diseases
• Immunology

Background:

• Post-acute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC), commonly known as long COVID, continues to be a significant health concern.
• Neurological symptoms are a common sequela of acute coronavirus disease-19 (COVID-19) infection.
• Similar symptoms to long COVID are observed in individuals without a history of COVID-19 infection.

Purpose of the Study:

• To compare antibody test results between patients with and without a history of acute COVID-19 infection presenting with PASC symptoms.
• To differentiate between true PASC and PASC-mimic conditions based on demographic and clinical characteristics.
• To identify clinical features aiding in the diagnosis of PASC, especially when acute infection is unconfirmed.

Main Methods:

• A single-center, retrospective, descriptive case series study was conducted.
• Data were collected from patients attending a PASC outpatient clinic between June 1, 2021, and May 31, 2023.
• Patients were categorized into true-PASC (confirmed infection and positive antibodies) and PASC-mimic (no confirmed infection and negative antibodies) groups for comparison.

Main Results:

• Of 222 patients tested, 193 (86.9%) had a history of confirmed acute COVID-19 infection, while 29 (13.1%) did not.
• Among those with confirmed infection, 186 (96.4%) were seropositive for anti-nucleotide SARS-CoV-2 antibodies (true-PASC).
• No significant differences in symptom characteristics were found between the true-PASC and PASC-mimic groups.

Conclusions:

• Diagnosing PASC without confirmed acute COVID-19 infection is challenging due to overlapping symptoms.
• A distinct 'PASC-mimic' condition exists and should be considered in research and clinical practice.
• Further studies are needed to establish diagnostic criteria that differentiate true PASC from PASC-mimic conditions.