1. Sign our petition calling on Cochrane to withdraw their review of Exercise Therapy for 'CFS'.
    Dismiss Notice
  2. Guest, the 'News in Brief' for the week beginning 2nd December 2024 is here.
    Dismiss Notice
  3. Welcome! Read the Core Purpose and Values of our forum.
    Dismiss Notice

Neurologic Manifestations of LC Disproportionately Affect Young and Middle-Age Adults, 2024, Natasha A. Choudhury MD et al

Discussion in 'Long Covid research' started by Mij, Nov 22, 2024.

  1. Mij

    Mij Senior Member (Voting Rights)

    Messages:
    9,720
    Objective
    To investigate neurologic manifestations of post-acute sequelae of SARS-CoV-2 infection (Neuro-PASC) in post-hospitalization Neuro-PASC (PNP) and non-hospitalized Neuro-PASC (NNP) patients across the adult lifespan.

    Methods
    Cross-sectional study of the first consecutive 200 PNP and 1,100 NNP patients evaluated at a Neuro-coronavirus disease 2019 (COVID-19) clinic between May 2020 and March 2023. Patients were divided into younger (18–44 years), middle-age (45–64 years), and older (65+ years) age groups.

    Results
    Younger and middle-age individuals accounted for 142 of 200 (71%) of PNP and 995 of 1100 (90.5%) of NNP patients. Significant age-related differences in the frequencies of comorbidities and abnormal neurologic findings demonstrated higher prevalence in older patients. Conversely, 10 months from COVID-19 onset, we found significant age-related differences in Neuro-PASC symptoms indicating lower prevalence, and therefore, symptom burden, in older individuals. Moreover, there were significant age-related differences in subjective impression of fatigue (median [interquartile range (IQR)] patient-reported outcomes measurement information system [PROMIS] score: younger 64 [57–69], middle-age 63 [57–68], older 60.5 [50.8–68.3]; p = 0.04) and sleep disturbance (median [IQR] PROMIS score: younger 57 [51–63], middle-age 56 [53–63], older 54 [46.8–58]; p = 0.002) in the NNP group, commensurate with higher impairment in quality of life (QoL) among younger patients. Finally, there were significant age-related differences in objective executive function (median [IQR] National Institutes of Health [NIH] toolbox score: younger 48 [35–63], middle-age 49 [38–63], older 54.5 [45–66.3]; p = 0.01), and working memory (median [IQR] NIH toolbox score: younger 47 [40–53], middle-age 50 [44–57], older 48 [43–58]; p = 0.0002) in NNP patients, with the worst performance coming from the younger group.

    Interpretation
    Younger and middle-age individuals are disproportionally affected by Neuro-PASC regardless of acute COVID-19 severity. Although older people more frequently have abnormal neurologic findings and comorbidities, younger and middle-age patients suffer from a higher burden of Neuro-PASC symptoms and cognitive dysfunction contributing to decreased QoL. Neuro-PASC principally affects adults in their prime, contributing to profound public health and socioeconomic impacts warranting dedicated resources for prevention, diagnosis and interventions.
    LINK
     
    Mij, Nov 22, 2024
    #1
    ahimsa, Kalliope, Hutan and 3 others like this.
  2. Sean

    Sean Moderator Staff Member

    Messages:
    8,180
    Location:
    Australia
    'New research shows younger & middle-aged adults have worse long COVID symptoms than older adults'

    I wonder if that is because older people are less physically active than younger/middle-aged people, and if that is some way is protective, especially in the critical early phase.

    Maybe older people, having more experience of the world and how their own bodies operate and where their limits are, are better equipped to listen to their bodies and less inclined to ignore the warning signals.
     
    Sean, Nov 23, 2024
    #2
    rvallee, Dolphin, Trish and 1 other person like this.
  3. Hutan

    Hutan Moderator Staff Member

    Messages:
    29,697
    Location:
    Aotearoa New Zealand
    Could just be different baselines for comparison, and different expectations. For example, an older person might have felt quite fatigued pre-Covid-19, whereas the young person was jogging 5 km every night. And the younger person might need to look after children and get to work and meet deadlines, whereas the over-65 year old is more likely to be able to just take things easy.

    Also I think they make a bit much of the differences. For fatigue in non-hospitalised group, mean (IQR)
    young: 64 (57-69)
    middle aged: 63 (57-68)
    old: 60.5 (50.8-68.3)
    Those aren't big differences, especially if you round 60.5 up to 61. (the young and middle aged results don't get decimals). And the p-value was only just significant (0.04)

    For sleep disturbance means: 57, 56, 54
    Executive function means: 48, 49, 54.5
    Working memory means: 47,50, 48

    Also, the older people with a slight impairment probably aren't turning up at the Neuro-coronavirus clinic whereas the younger ones are. I imagine there are quite a few older people like my 92 year old aunt who says 'I get more tired that I was before my Covid-19 infection, but oh well, what can you do? I guess I'm getting older'. Whereas the 35 year old mother of two who works full time and does pilates sessions in her lunch-time will notice even a fairly mild decrease in function and get referred through to the clinic.
     
    Hutan, Nov 23, 2024
    #3
    Sean, rvallee, Dolphin and 3 others like this.

Share This Page