Authors: Viviane Ugalde, Ellese Lupori, Fanglong Dong, Lee Raunig, Lindsay Hagler, Jesse Bledsoe.
After the event of a concussion, patients may experience a combination of cognitive, physical, and affective symptoms that impact their daily life. Management of concussion should consider the various personal histories and external stressors that contribute to a patient’s symptom burden and recovery. The aim of this study is to quantify the impact of the COVID-19 pandemic on concussion symptoms and recovery time in a cohort of adolescents. The study is a secondary data analysis of ImPACT Concussion Test symptom scores and electronic health records from a cohort of adolescents between the ages of 12-18, pre-pandemic (January 1, 2015 - March 20, 2020) and pandemic (March 21, 2020 - April 1, 2022). Symptom prevalence of trouble falling asleep, irritability, nervousness, sadness, feeling more emotional, headache, nausea, balance problems, dizziness, sensitivity to noise, sensitivity to light and visual problems were recorded. Recovery times were pulled from patient records on return to full competition. A total of pre-pandemic non-concussed (n =2104), pre pandemic concussed (n=437), pandemic non- concussed (n = 492) and pandemic concussed (n=71) were included in the final analysis. Adolescents concussed during the pandemic experienced statistically significantly more irritability (p=0.0008), nervousness (p=0.0048), sadness (p=0.0018), feeling more emotional (p=0.0060), balance problems (p=0.0310), and visual problems (p=0.0002) than adolescents concussed before the pandemic. Owing to multiple biopsychosocial considerations, return to activity was prolonged in adolescents concussed during the pandemic as compared to before. Affective symptoms increased during the pandemic in the general pediatric population, however this study demonstrates the additional burden the pandemic had on adolescents with concussion. These findings suggest that affective symptoms place burden on somatic healing from injury, and further encourages a biopsychosocial approach to injury management, in which social and emotional challenges of a patient's life are considered.
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