High Somatization Rates, Frequent Spontaneous Recovery, and a Lack of Organic Biomarkers in Post-Covid-19 Condition

Area of Science:

• Neurology
• Infectious Diseases
• Psychiatry

Background:

• Neuropsychiatric symptoms are frequently reported following SARS-CoV-2 infection.
• Post-COVID-19 condition (PCC) diagnosis is challenging due to unspecific symptoms and lack of biomarkers.
• Prevalence data for PCC vary significantly.

Purpose of the Study:

• To investigate the prevalence and characteristics of neuropsychiatric symptoms in PCC patients.
• To evaluate potential biomarkers (SARS-CoV-2 antibodies, EBV antibodies, cortisol) in PCC.
• To track symptom evolution and recovery rates in a cohort of PCC patients.

Main Methods:

• Prospective follow-up of 175 PCC patients over 18 months in a neurological outpatient setting.
• Assessment of neurological and neuropsychiatric symptoms using validated questionnaires (PHQ-D, MoCA, ISS, ESS, FSS).
• Analysis of SARS-CoV-2 antibodies, Epstein-Barr virus antibodies, and cortisol levels as potential biomarkers.

Main Results:

• Fatigue, stress intolerance, and cognitive deficits were the most common initial symptoms.
• High prevalence of fatigue (95%), insomnia (62.1%), and sleepiness (44.0%) was observed.
• Somatization (61%) and psychiatric disorders (28%) were prevalent; 76.8% of patients showed symptom improvement by the third visit, with 51.2% becoming symptom-free.
• Biomarker analysis did not confirm anti-EBV responses; SARS-CoV-2 antibodies increased over time, and cortisol levels remained physiological.

Conclusions:

• PCC patients exhibit a high initial symptom burden, but a significant majority improve over time.
• Somatization and psychiatric disorders are common comorbidities in PCC.
• Current data do not support previously suggested biomarkers for PCC diagnosis or management.