Patients received care at Massachusetts General Hospital between February 2020 and May 2021. Patients that required hospitalization (27.6% of those with confirmed SARS-CoV-2 infection, 7.7% of nonconfirmed cases) had moderate illness at most, requiring only brief hospitalization, and no supplemental oxygen, intubation, or mechanical ventilation. The majority of enrolled patients had mild illness that was managed in the outpatient setting (72.4% of those with confirmed SARS-CoV-2 infection, 92.3% of nonconfirmed cases). This preliminary study represents a retrospective cohort-nested design within our prospective cohort study of COVID-19 survivors comprising men and women who have received care due to persistent COVID-19 symptoms. To understand this syndrome, a multidisciplinary approach is needed and extensive future research in this area is imperative and necessary in order to establish the most effective course of treatment for these patients and to facilitate robust and sustained recovery from this pandemic. We explored whether there was any specific signature of cognitive impairment in SARS-CoV-2, and we hypothesized that clinically, PASC would have subgroup presentations and that “brain fog,” as termed by the media as well as patients, would have many different meanings, with high incidence of executive dysfunction (attentional complaints, encoding/retrieval memory problems, and word-finding difficulties), anxiety, depression, and sleep difficulties affecting frontal and subcortical networks the most. Here, we share our clinical experience and observation of this new syndrome, describing the neuropsychiatric manifestations of PASC in a sample of patients seen at the Henry and Allison McCance Center for Brain Health and Neuropsychiatry Clinics at Massachusetts General Hospital. While postviral syndromes have been described for an array of viral illnesses, the postviral syndrome for SARS-CoV-2, termed “post-acute sequelae of SARS-CoV-2 infection” (PASC) or “long COVID,” has yet to be fully characterized, and its natural history and prevalence are unknown ( 1).Īn array of persistent neuropsychiatric symptoms, such as cognitive impairment, depression, anxiety, fatigue, and insomnia, have been reported by patients in the aftermath of their initial COVID-19 infection, but there has been a call for more research to clarify the PASC syndrome ( 2). In its wake, the virus continues to inflict suffering as many individuals experience persistent symptoms after the acute phase of the infection. The novel coronavirus (SARS-CoV-2), first detected in December of 2019, has raged across the globe, causing immense suffering and loss of life.

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