Characterizing Symptoms and Impact of “Long Covid”: A Qualitative Perspective

RESEARCH OBJECTIVES: To characterize the nature and impact of physical, cognitive, and mood symptoms associated with Post-Acute Covid-19 Syndrome (PACS). DESIGN: Qualitative study utilizing semi-structured interviews adapted from the McGill Illness Narratives Interview (MINI) and the Work Rehabilitation Questionnaire (WORQ). Interviews were coded and analyzed using grounded theory methodology. SETTING: Outpatient general rehabilitation clinic in Chicago, November 2021-March 2022. PARTICIPANTS: Convenience sample of eight adult English-speaking individuals who met WHO Criteria for PACS. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Not applicable. RESULTS: Individuals reported a wide range of physical, cognitive and communication, and mood changes associated with PACS. Cognitive changes included slow processing, and difficulties with attention, working memory, short term memory, executive function, abstract reasoning, and cognitive endurance. comprehension, word finding, executive function, working memory, attention, abstract reasoning, cognitive endurance, and short-term memory. Physical changes included profound physical fatigue, insomnia, and daytime tiredness. Mood changes included anxiety, depression, and relapse of previously diagnosed psychiatric conditions. Timeline, duration, severity, and distribution of symptoms varied widely between individuals. Several themes emerged regarding impact of symptoms: (1) difficulty performing instrumental activities of daily living; (2) struggles with verbal communication leading to social isolation, difficulty with collaborative work, and feelings of shame and humiliation; (3) profound impact on self-image and perceptions of the future; (4) profound impact on ability to work, job performance, retirement plans, and relationship with employer; and (5) the utilization of both novel and previously developed coping mechanisms. Finally, individuals reported diverse perspectives on the utility of rehabilitation therapies. These included the perception of rehabilitation therapies as empowering, useful, beneficial, transformative, confidence-inspiring, depressing, confusing, disempowering, useless, or needless. CONCLUSIONS: In light of the diversity of physical, cognitive, and emotional symptoms associated with PACS, a highly individual approach to rehabilitation planning is needed for individuals with PACS. Further research is needed to understand patient attitudes and perspectives about rehabilitation therapy, which should be utilized to develop patient education efforts in the future. AUTHOR(S) DISCLOSURES: Supported by KIWANIS Neurologic Research fund. Authors have no disclosures.