# Mental and Physical Health in Wilson Disease Patients With SARS‐CoV‐2 Infection and Relevance of Long‐COVID

## TL;DR

This study shows that Wilson disease patients experience significant physical and mental health decline after SARS-CoV-2 infection, with many developing Long-COVID symptoms.

## Contribution

The study is the first to investigate Long-COVID in Wilson disease patients, revealing its impact on their physical and mental health.

## Key findings

- WD patients showed significantly worse physical quality of life, sleep quality, and fatigue after SARS-CoV-2 infection.
- 39.2% of WD patients were classified as having Long-COVID, with impaired quality of life and cognitive issues.
- Common Long-COVID symptoms included fatigue, brain fog, and reduced exercise capacity in WD patients.

## Abstract

SARS‐CoV‐2 infection and Long COVID (LC) might lead to a significant deterioration of physical and mental health. Wilson disease (WD) patients have a chronic liver and/or neuropsychiatric disease, making it particularly interesting to investigate LC in WD. 51 WD patients were retrospectively examined, evaluating physical and mental health by a survey and neuropsychological tests (SF‐12, PSQI, ISI, Epworth, Chalder‐fatigue scale, PHQ‐9, GAD‐7, PSS, FLei) before and ~11 months after SARS‐CoV‐2 infection. LC was defined as the development of new, at least moderately severe symptoms (shortness of breath, chest pain, fatigue, brain fog, exercise capacity, concentration disturbances) and/or worsening of pre‐existing symptoms. 70.6% had predominant hepatic and 29.4% had neuropsychiatric symptoms at WD diagnosis. Median age was 39 years; 56.1% were female. Patients were in stable maintenance phase with a median treatment duration of 23 years. When compared to before COVID‐19, WD patients had significantly worse physical life quality, sleeping quality, and fatigue. After COVID‐19, a high percentage of WD patients reported concentration disorders (60%), fatigue (55%), reduced exercise capacity (50%), shortness of breath (40%), chest pain (20%) and feeling of brain fog (15%). 39.2% (n = 20) of the WD patients were classified as LC. This LC‐WD subgroup showed significantly impaired quality of life, a high stress level, and sleeping disturbances, fatigue, depression, anxiety, and cognitive impairment. A large proportion of WD patients experience LC symptoms, reduced life quality, and sleeping disorders after SARS‐CoV‐2 infection. WD patients post‐infection should be well monitored and supported if they develop persisting symptoms or neuro‐psychological problems.