Outcomes of Patients with Neurocognitive Symptoms Attending a Long COVID Clinic: A Longitudinal Cohort Study

Data are lacking on longitudinal outcomes of patients treated in primary care-led long COVID (LC) clinics.

Assess changes in health-related quality of life (HRQoL) in patients with LC and neurocognitive symptoms from enrollment in a LC clinic to 6 months post-enrollment.

Observational cohort study.

Primary care-led LC clinic at an academic medical center.

One hundred fifty patients with long COVID and neurocognitive symptoms who completed the PROMIS29 inventory at clinic enrollment and 6 months post-enrollment.

Multimodality care consisting of disease education and behavioral management, rehabilitative therapies, and pharmacotherapy for LC symptoms.

Treatments received and change in PROMIS29 t-scores from enrollment to 6-month follow-up.

T-scores (mean, SE) at clinic entry were worse than the population mean (50) for fatigue (65.6, 1.05), sleep disturbance (57.3, 1.00), anxiety (60.0, 1.26), physical function (37.9, 0.87), social role participation (40.2, 0.84), pain (60.1, 1.24), and depression (57.3, 1.11). Patients received multimodality treatment consisting of disease education and behavioral management (all patients), combined rehabilitation and pharmacotherapy (44%), rehabilitation only (22%), or pharmacotherapy only (16%). There were statistically significant improvements in mean t-scores in all PROMIS29 domains at 6 months. Clinically significant improvement (change in t-score of ≥ 2.5) was seen for physical functioning (+ 2.9, 0.58), fatigue (- 4.9, 0.80), social functioning (+ 3.4, 0.68), and pain (- 2.8, 0.88). Change in t-score > 5 was seen in fatigue with symptom-titrated physical rehabilitation, in fatigue and pain with amantadine and memantine, and in sleep disturbance and pain with trazodone and amitriptyline.

Multimodal symptom-directed interventions incorporating rehabilitation alongside targeted pharmacotherapy were associated with significantly improved HRQoL in patients with LC and neurological symptoms.