![]() ![]() Read: ‘ICU delirium’ is leaving COVID-19 patients scared and confusedīut no one was prepared for the second wave of neurocognitive complaints, which came from people who had never been hospitalized. “A pneumonia patient in the ICU can be delirious,” Abramoff says. The sickest patients can experience hallucinations and psychoses. Many of those who survived with the help of ventilators emerged, expectedly, with “post-ICU syndrome,” a series of deficits that include memory, attention, and processing-speed impairments. physicians, he was abruptly introduced to COVID-19 a year ago, when hospitals were inundated with critically ill patients-some of whom suffered brain damage from oxygen loss, blood clots, or strokes. Benjamin Abramoff, the director of Penn’s post-COVID clinic, is a physiatrist with a specialty in spinal-cord injury. While identifying long-COVID patients is challenging, helping them through the uncharted territory of their illness is more difficult still. Now, in the second year of the pandemic, researchers and therapists are beginning to understand how to help them. Like Gustafson, many of them are struggling with brain fog, and with its profound and often frightening disruptions to their daily lives. “It’s likely there are many millions of these patients in the U.S., and dozens of millions in the world,” Koralnik told me. That Koralnik’s study, like many of the new clinics, probably does not include many people without the resources or connections to find their way to specialized care only increases the uncertainty. “There’s no numerator or denominator for the group yet,” says Sara Manning, a neurologist at the new Post-COVID Assessment and Recovery Clinic at the University of Pennsylvania, one of dozens of such clinics springing up in the United States and worldwide. But official recognition doesn’t tell us what percentage of COVID-19 sufferers experience lingering neurocognitive problems, or how many long-COVID patients there are. ![]() In February, the National Institutes of Health gave long COVID a clinical name: Post-Acute Sequelae of SARS-CoV-2 infection (PASC). None had ever been hospitalized for COVID-19, yet 85 percent had four or more neurological complaints, including “brain fog”-persistent trouble with focusing, retaining short-term memories, and managing complex tasks. A just-published study led by Igor Koralnik, the director of the Neuro COVID-19 Clinic at Chicago’s Northwestern Memorial Hospital, analyzed the first 100 “long COVID” sufferers who came to the clinic, either in person or via virtual visits. The cognitive problems emerging from mild to moderate cases of COVID-19 are so new that researchers have struggled to define them. Before COVID-19, she’d held two part-time jobs, but she soon had to give up both of them. Once an avid reader, she couldn’t get through a page. Though her physical symptoms-diarrhea, dry cough, chills-were considered mild by doctors, her fatigue was crushing, and her mind was trapped in a fog. Debbie Gustafson of Dresher, Pennsylvania, was on the trip of a lifetime, touring the Galápagos with her family last March, when she began to feel the effects of COVID-19.
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