Journal Article

Characterizing Neuro-PASC outcome with the mobile Neuro-COVID recovery care companion application

Jimenez, Millenia, Duax, C. J., Liotta, Eric M., Gaelen, Jordan I., Blahnik, David, Lank, Grace K., Lopez, Melissa, Mukherjee, Shreya, Hanson, Barbara A., Bawa, Aasheeta P., Budhiraja, Shreya, Venkatesh, Aditi, Bharadwaj, Shreyas, Koralnik, Igor J., Miller, Janet, King, Doug, Batra, Ayush, Singer, Tracey

2026

Overview

Background Long COVID, or post-acute sequelae of SARS-CoV-2 infection (PASC), affects 14 million people in the US. Neurologic manifestations of PASC (Neuro-PASC) are particularly debilitating. However, the evolution of these symptoms and factors associated with recovery are poorly understood. This study aimed to characterize Neuro-PASC symptom evolution using a mobile phone application and assess user experience. Methods The Neuro-COVID Recovery Care Companion (NCRCC) mobile application consists of questionnaires integrated within Northwestern Medicine’s online MyChart platform which interfaces with the electronic medical record. Neuro-PASC patients completed daily surveys of twelve Neuro-PASC symptoms and their perceived percent recovery compared to their pre-COVID baseline. Patients also completed Patient-Reported Outcomes Measurement Information System (PROMIS) quality-of-life (QoL) surveys and NIH toolbox cognitive assessments at baseline and at 3-month follow up. Participants were retrospectively classified as “Improvers” or “Non-Improvers” based on the slope and range of their percent subjective recovery. Results Data from 63 participants presenting an average of 12.7 months after symptom onset were analyzed, including 27 (42.9%) Improvers and 36 (57.1%) Non-Improvers. Fewer women were Improvers (50% vs 75.7%; p  = 0.04). Multiple correspondence analysis showed that patients presenting with a constellation of anosmia, dysgeusia, and a lack of insomnia ( p  = 0.023) were less likely Improvers. Improvers had more fluctuations in their subjective recovery than Non-Improvers with greater mean variance (7.01 vs 3.79; p  = 0.0004) and positive recovery slope (5.84 vs 0; p  < 0.0001). There were no differences in QoL and cognition at initial assessment, but Improvers showed a trend toward increased processing speed and decreased sleep disturbance after 3 months. Both groups found the NCRCC application easy-to-use, useful, and satisfactory. Conclusions Our findings reveal previously unrecognized fluctuations in subjective recovery of Neuro-PASC, and that women and patients presenting with anosmia and dysgeusia are less likely to improve one year from COVID-19 onset. We found broad alterations in QoL in both groups suggesting that strategies to reduce sleep disturbance and improve cognition may contribute to subjective improvement. Our results suggest similar mobile applications may benefit patients with other ill-defined chronic diseases, by equipping and empowering them on their often windy road to recovery.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aged / Anosmia / Application / Care and treatment / Cognition & reasoning / Comparative analysis / Complications / COVID-19 / COVID-19 - complications / Diagnosis / Electronic medical records / Enrollments / Female / Health aspects / Humans / Long COVID / Male / Medicine / Medicine & Public Health / Middle Aged / Mobile Applications / Nervous System Diseases - etiology / Neurochemistry / Neurologic manifestations of general diseases / Neurology / Neurosurgery / Patient outcomes / Patient Reported Outcome Measures / Patients / Post-Acute COVID-19 Syndrome / Post-Acute Sequelae of SARS-CoV-2 Infection (PASC) / Quality of Life / Questionnaires / Retrospective Studies / SARS-CoV-2 / Severe acute respiratory syndrome coronavirus 2 / Sleep disorders / Smartphones / Surveys / Surveys and Questionnaires / Symptom tracker / Variables