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Fatigue, Brain Fog  And A Racing Heart — What Doctors Are Learning About Post-COVID Neurodivergence

Fatigue, Brain Fog And A Racing Heart — What Doctors Are Learning About Post-COVID Neurodivergence

Forbes15-07-2025
FAIRFAX, VA- February 3 : Eve Efron, who has been struggling with long covid for nearly a year, ... More frequently has to rest on the couch in her home in Fairfax, VA on February 3, 2022. She was denied temporary disability by Mutual of Omaha from her job at a PR firm after her doctor recommended she take time off. Her symptoms include significant fatigue, brain fog, anxiety and depression. (Photo by Carolyn Van Houten/The Washington Post via Getty Images)
Have you ever made people gasp by bending your knees backwards or touching your thumb back to your arm? Does your pulse race when you stand up? Do you have a history of gastric issues or irritable bowel syndrome? Are you also neurodivergent, by any chance?
There is emerging, but compelling, evidence that the overlap between neurodivergence, hypermobility syndromes, mast cell activation syndrome, postural orthostatic tachycardia and dysautonomia is not a coincidence, and has a lot to do with COVID.
The impact of these conditions can be severe on their own, though hard to diagnose and lacking in conclusive biomarkers. They lead to chronic fatigue, serious gastro-intestinal distress, brain fog and concentration difficulties, anxiety and depression. People drop out of the labor force, education and careers are curtailed. Prevalence rates are very hard to come by reliably, but estimates range up to 20% of the population affected by one or more of these conditions. Physicians have noticed that these diagnoses are also rising exponentially since COVID, which appears to trigger or exacerbate symptoms.
An Invisible Problem Hiding In Plain Sight
A special meeting at the Royal Society of Medicine (RSM) in London has concluded that neurodivergent people, who are more likely to have hypermobility, connective tissue and autoimmune conditions, have been disproportionately impacted by COVID, and that this is having a significant impact on our ability to go to school and work. The rise in neurodivergence since 2020 that is placing so much strain on education and health services, the tax payer and not forgetting the individuals themselves and their families, is indeed partly due to increased awareness and more accessible diagnostic criteria – as has already been argued. However, this does not explain why these high rates of diagnosis are accompanied by such vastly increased rates of school absence and inability to work. If neurodivergent people have always existed, why are we only now so unwell that we can't work?
The presentations to the RSM suggested that the effects of COVID on the brain could be contributing to the skyrocketing ADHD and Autism diagnosis waiting lists and to the absence epidemic. Since COVID we've needed to ask for help, whereas before we could fly under the radar.
Some people have dropped out of work or school altogether and are now battling to have their illness recognized. Others are still attending, but battling their own bodies, trying to force themselves to work through increasing difficulties with memory, unpredictable energy levels, pain, unstable pulse rates and various allergic inflammation. Their capacity for their work has been drastically reduced, they don't know why and try as they might to get better, it's not working. They are likely to be prescribed anxiety or depression medication in primary care and go looking for psychological answers to physical problems. Indeed, many of the markers we look for in diagnosing anxiety are, in fact, expressions of our nervous system – pounding heart rate, dizziness, hot / cold flushes. It is too easy to assign symptoms to stress and very difficult to identify the connections across the whole system.
The Solution Is Also Hiding In Plain Sight
It has taken a mixed group of medical experts in immunology, rheumatology, cardiology, urology, psychiatry and neuro-gastroenterology to connect the dots. At the RSM, they presented clear data indicating that for people with this overlapping group of conditions, neurocognitive and emotional symptoms have indeed increased. We're not making it up! Physical symptoms that were triggered by COVID infections have lowered our tolerance for sensory sensitivity in noise, smell, temperature, texture, light, food allergens, mould and all the toxicity in our environment. People who were neurodivergent a decade ago but coping in education and careers are now too ill to do so, and the effects of neuroinflammation could tip a sub-clinical neurotype into diagnosis territory.
The meeting further presented the extraordinary evidence that effective treatments for these issues are already available, such as anti-histamines, probiotics, mast cell stabilisers – simple, cheap, low risk medications which have made the difference between someone working and not working. One of the presenters, Dr Stephanie Barrett, MBChB, MD, FRCP, a Consultant Rheumatologist, reported that non pharmacological and non-invasive treatment such as repeated transcranial magnetic stimulation (rTMS) has also been found to be beneficial. She reports:
"RTMS (neuromodulation) was an extraordinary breakthrough for the treatment of depression. Now using a different protocol, we have shown that we can treat severe fibromyalgia with associated fatigue and dysautonomia, in patients who are stuck for decades in the pain/ fatigue prison.
The additional challenge for our patients is 80% prevalence of neurodivergence. All the complex physical conditions and associations are treatable but they need to be recognised first. We could set up hubs with the government, at low cost to treat all these conditions and return people of all ages to education and the workforce."
Each specialist presented various statistics, using many of the same treatments, indicating that a clear majority of their patients who were neurodivergent and unable to work before treatment are now back in work following an affordable protocol. Careers resumed, stories of people who feel they have 'got their life back'.
Believe People When They Say They Are Ill
In a country where productivity has dived since the financial crisis, and the health of the nation has not recovered from COVID, The Royal Society of Medicine are trying to understand the root causes, rather than paper over the end results. Neurodivergent people are at risk of losing their support from welfare payments due to changes to the benefits system, which could underrate the presence of multiple, mid-level symptoms, even though these all add up to a significant drain. Whilst political circles are arguing over the extent to which the population is malingering versus 'genuinely' ill, this group of physicians have come above the squabbling with a potential lever to tip the system from decline to healing. Following their proposed protocols, we can believe people who say that they can't cope, treat them and support their recovery to living a full life again.
Neurodivergent people of all ages have been stopped in their tracks, creating career and educational hiatuses that cause long term damage. We are at risk of a lost generation of working age people who cannot understand their fatigue, who are trying their hardest but just cannot get moving, the more they try the harder it is (see: post-exertion malaise). If you think you might be affected by any of these conditions, take an inventory of your symptoms, however disjointed they are, and talk to your primary care physician. Even if they can't refer you to a specialist, they owe you an explanation for your difficulties, so remember to be clear about what's happening. It is so easy to write off fatigue and poor concentration as 'stress' – but stress existed before the pandemic. If your capacity has changed, and you feel like it's increasingly hard to cope with work you previously enjoyed or found easy, then this could be a physiological problem and you should speak to your doctor.
Is COVID to blame for the rise in neurodivergence? The answer is complex. We have higher levels of awareness and improved diagnostic criteria. For children, we have failing schools where rigid curricula and draconian discipline disproportionately disadvantage neurodivergent children. In workplaces we have increasing demands for productivity rises and endless escalation of technology and surveillance. All this undoubtedly contributes to the absence epidemic, but all of it started before the pandemic. It doesn't fully explain the stark differences some studies showing that school absence has doubled from 2017 to 2023. The Royal Society of Medicine took some time to come at this problem from a less obvious angle, and in doing so have brought a cost effective solution into the light. It's time to stop assuming that people are lazy and time to stop putting multi-system health issues in the 'too difficult box.' As employers, as a country and as individuals with families to support, we can't afford to ignore the rising absence any longer.
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It is recommended that participants join 10 minutes prior to the start of the call, although participants may register and join at any time during the call. A live webcast of Labcorp's quarterly conference call on July 24, 2025, will be available at the Labcorp Investor Relations website beginning at 9:00 a.m. ET. This webcast will be archived and accessible through July 11, 2026. About Labcorp Labcorp (NYSE: LH) is a global leader of innovative and comprehensive laboratory services that helps doctors, hospitals, pharmaceutical companies, researchers and patients make clear and confident decisions. We provide insights and advance science to improve health and improve lives through our unparalleled diagnostics and drug development laboratory capabilities. The company's nearly 70,000 employees serve clients in approximately 100 countries, provided support for 75% of the new drugs and therapeutic products approved in 2024 by the FDA, and performed more than 700 million tests annually for patients around the world. Learn more about us at Cautionary Statement Regarding Forward-Looking Statements This press release contains forward-looking statements, including, but not limited to, statements with respect to (i) the estimated 2025 guidance and related assumptions, (ii) the impact of various factors on operating and financial results, including the projected impact of global economic and market conditions on the company's businesses, operating results, cash flows and/or financial condition, (iii) future business strategies, (iv) expected savings, synergies and other benefits to the Company, customers or patients from acquisitions and other transactions and partnerships, and (v) opportunities for future growth. Each of the forward-looking statements is subject to change based on various important factors, many of which are beyond the company's control, including without limitation: (i) the effect of the holding company reorganization on the company's business generally; (ii) the failure to receive tax-free treatment with respect to the spin-off of the company's Clinical Development and Commercialization Services business, now Fortrea Holdings Inc. for U.S. federal income purposes; (iii) the impact of spin-off related items; (iv) personnel costs and potential difficulties with employee relations and retention; (v) the trading price of the company's stock, competitive actions and other unforeseen changes and general uncertainties in the marketplace; (vi) changes in government regulations, including healthcare reform; (vii) customer purchasing decisions, including changes in payer regulations or policies; (viii) adverse actions of governmental and third-party payers; (ix) changes in testing guidelines or recommendations; (x) the volume of COVID-19 Testing performed by the company; (xi) the impact of global geopolitical events; (xii) the effect of public opinion on the company's reputation; (xiii) adverse results in material litigation matters; (xiv) changes in laws and regulations applicable to the company, including healthcare reform, and changes to their interpretation and application and the impact of any such changes; (xv) failure to maintain or develop customer relationships; (xvi) the company's ability to develop or acquire new products and adapt to technological changes; (xvii) failure of the company's information technology, systems, or data security; (xviii) the impact of potential losses under repurchase agreements; (xix) adverse weather conditions; (xx) the number of revenue days in a financial period; (xxi) inflation; (xxii) increased competition; and (xxiii) the effect of exchange rate fluctuations. These factors, in some cases, have affected and in the future (together with other factors) could affect the company's ability to implement the company's business strategy, and actual results could differ materially from those suggested by these forward-looking statements. As a result, readers are cautioned not to place undue reliance on any of the forward-looking statements. The company has no obligation to provide any updates to these forward-looking statements even if its expectations change. All forward-looking statements are expressly qualified in their entirety by this cautionary statement. Further information on potential factors, risks and uncertainties that could affect operating and financial results is included in the company's most recent Annual Report on Form 10-K under the heading RISK FACTORS and in the company's other filings with the SEC. The information in this press release should be read in conjunction with a review of the company's filings with the SEC including the information in the company's most recent Annual Report on Form 10-K under the heading "MANAGEMENT'S DISCUSSION AND ANALYSIS OF FINANCIAL CONDITION AND RESULTS OF OPERATIONS". - End of Text - - Tables to Follow - LABCORP HOLDINGS INC. AND SUBSIDIARIES CONSOLIDATED STATEMENTS OF OPERATIONS (In Millions, Except Per Share Data) Three Months Ended June 30,Six Months Ended June 30,2025202420252024 Revenues $ 3,527.3$ 3,220.9$ 6,872.4$ 6,397.5 Cost of revenues 2,481.12,294.54,878.24,573.8 Gross profit 1,046.2926.41,994.21,823.7 Selling, general, and administrative expenses 579.3557.81,125.31,066.2 Amortization of intangibles and other assets 68.362.2137.9122.3 Goodwill and other asset impairments ———2.5 Restructuring and other charges 4.111.610.516.6 Operating income 394.5294.8720.5616.1 Other (expense) income:Interest expense (57.1)(47.6)(113.1)(94.5) Investment income 1.71.38.24.2 Equity method loss, net (1.7)(0.3)(2.0)(0.2) Other, net (32.7)19.5(33.7)39.5 Earnings from operations before income taxes 304.7267.7579.9565.1 Provision for income taxes 66.462.1128.6131.2 Net earnings 238.3205.6451.3433.9 Less: Net earnings attributable to the noncontrolling interest (0.4)(0.3)(0.6)(0.6) Net earnings attributable to Labcorp Holdings Inc. $ 237.9$ 205.3$ 450.7$ 433.3 Earnings per common share:Basic earnings per common share $ 2.85$ 2.44$ 5.40$ 5.15 Diluted earnings per common share $ 2.84$ 2.43$ 5.36$ 5.13 Weighted-average basic common shares outstanding 83.484.183.584.1 Weighted-average diluted common shares outstanding 83.984.384.184.5 LABCORP HOLDINGS INC. AND SUBSIDIARIES CONSOLIDATED BALANCE SHEETS (In Millions) June 30, 2025December 31, 2024 ASSETSCurrent assets:Cash and cash equivalents $ 647.3$ 1,518.7 Accounts receivable, net 2,120.61,944.1 Unbilled services 156.1152.9 Supplies inventory 508.1493.2 Prepaid expenses and other 655.1697.6 Total current assets 4,087.24,806.5 Property, plant, and equipment, net 3,133.83,045.4 Goodwill, net 6,551.16,369.7 Intangible assets, net 3,494.43,488.9 Joint venture partnerships and equity method investments 160.416.3 Other assets, net 633.0652.2 Total assets $ 18,059.9$ 18,379.0 LIABILITIES AND SHAREHOLDERS' EQUITYCurrent liabilities:Accounts payable $ 793.0$ 875.8 Accrued expenses and other 835.8871.2 Unearned revenue 398.0392.2 Short-term operating lease liabilities 186.1184.6 Short-term finance lease liabilities 4.36.1 Short-term borrowings and current portion of long-term debt 499.61,000.3 Total current liabilities 2,716.83,330.2 Long-term debt 5,077.35,331.2 Operating lease liabilities 713.1676.3 Financing lease liabilities 65.674.3 Deferred income taxes and other tax liabilities 354.5383.1 Other liabilities 643.2517.4 Total liabilities 9,570.510,312.5 Commitments and contingent liabilitiesNoncontrolling interest 16.714.3 Shareholders' equity:Common stock, 82.9 and 83.4 shares outstanding at June 30, 2025, and December 31, 2024, respectively 7.57.6 Additional paid-in capital 1.82.8 Retained earnings 8,498.08,303.4 Accumulated other comprehensive loss (34.6)(261.6) Total shareholders' equity 8,472.78,052.2 Total liabilities and shareholders' equity $ 18,059.9$ 18,379.0 LABCORP HOLDINGS INC. AND SUBSIDIARIES CONSOLIDATED STATEMENTS OF CASH FLOWS (In Millions) Three Months Ended June 30,Six Months Ended June 30,2025202420252024 CASH FLOWS FROM OPERATING ACTIVITIES:Net earnings $ 238.3$ 205.6$ 451.3$ 433.9 Adjustments to reconcile net earnings to net cash provided by operating activities:Depreciation and amortization 170.3156.9337.1311.4 Stock compensation 34.130.866.962.4 Operating lease right-of-use asset expense 50.844.599.488.6 Goodwill and other asset impairments ———2.5 Deferred income taxes (6.1)(19.6)(12.2)(39.1) Other, net 38.039.646.136.6 Change in assets and liabilities (net of effects of acquisitions and divestitures):Decrease (increase) in accounts receivable 30.9(5.1)(139.9)(192.2) Decrease (increase) in unbilled services 0.9(37.1)4.826.8 (Increase) decrease in supplies inventory (11.9)28.3(3.5)27.7 Decrease in prepaid expenses and other 12.846.557.821.6 Increase (decrease) in accounts payable 67.069.4(80.6)(51.7) Increase (decrease) in unearned revenue 0.210.8(8.7)(30.8) Decrease in accrued expenses and other (4.7)(9.5)(179.4)(166.4) Net cash provided by operating activities 620.6561.1639.1531.3 CASH FLOWS FROM INVESTING ACTIVITIES:Capital expenditures (77.9)(128.2)(203.9)(262.0) Proceeds from sale of assets 1.90.12.40.2 Proceeds from sale or distribution of equity affiliates or other investments 6.9—6.9— Proceeds from sale of business ———13.5 Purchase of equity affiliates or other investments (15.0)(23.0)(172.0)(36.7) Acquisition of businesses, net of cash acquired (10.0)(33.9)(63.5)(293.1) Net cash used for investing activities (94.1)(185.0)(430.1)(578.1) CASH FLOWS FROM FINANCING ACTIVITIES:Payments on senior notes ——(1,000.0)— Proceeds from revolving credit facilities —698.764.8951.9 Payments on revolving credit facilities —(721.3)(64.8)(932.1) Proceeds from accounts receivable securitization ——225.0— Net share settlement tax payments from issuance of stock to employees (3.5)(23.1)(29.0)(37.8) Net proceeds from issuance of stock to employees ——25.726.7 Dividends paid (59.9)(60.4)(121.5)(122.5) Purchase of common stock (200.0)(100.0)(200.0)(100.0) Other, net (4.0)(3.9)(7.3)(7.9) Net cash used for financing activities (267.4)(210.0)(1,107.1)(221.7) Effect of exchange rate changes on Cash and cash equivalents 18.8(0.3)26.7(3.2) Net increase (decrease) in Cash and cash equivalents 277.9165.8(871.4)(271.7) Cash and cash equivalents at beginning of period 369.499.31,518.7536.8 Cash and cash equivalents at end of period $ 647.3$ 265.1$ 647.3$ 265.1 LABCORP HOLDINGS INC. AND SUBSIDIARIES Condensed Combined Non-GAAP Segment Information (Dollars in Millions) Three Months Ended June 30,Six Months Ended June 30,2025202420252024 Diagnostics LaboratoriesRevenues $ 2,748.8$ 2,524.9$ 5,378.4$ 5,004.6 Adjusted operating income $ 482.8$ 441.5$ 910.3$ 859.4 Adjusted operating margin 17.6 %17.5 %16.9 %17.2 % Biopharma Laboratory ServicesRevenues $ 784.8$ 707.0$ 1,506.1$ 1,417.9 Adjusted operating income $ 123.3$ 107.4$ 230.2$ 207.3 Adjusted operating margin 15.7 %15.2 %15.3 %14.6 % ConsolidatedRevenues $ 3,527.3$ 3,220.9$ 6,872.4$ 6,397.5 Adjusted segment operating income $ 606.1$ 548.9$ 1,140.5$ 1,066.7 Unallocated corporate expense (74.5)(69.0)$ (139.9)$ (134.0) Consolidated adjusted operating income $ 531.6$ 479.9$ 1,000.6$ 932.7 Adjusted operating margin 15.1 %14.9 %14.6 %14.6 % The consolidated revenue and adjusted segment operating income are presented net of intersegment transaction eliminations and other amounts not used in determining segment performance. Adjusted operating income and adjusted operating margin are non-GAAP measures. See the subsequent reconciliation of non-GAAP financial measures. LABCORP HOLDINGS INC. AND SUBSIDIARIES Reconciliation of Non-GAAP Measures (Dollars and Shares in Millions, Except Per Share Data) Three Months Ended June 30,Six Months Ended June 30, 2025202420252024Adjusted Operating Income Operating income$ 394.5$ 294.8$ 720.5$ 616.1 Amortization of intangibles and other assets (a)68.362.2137.9122.3 Restructuring and other charges (b)4.111.610.516.6 Acquisition and disposition-related costs (c)15.125.144.246.0 Launchpad costs (d)17.231.537.340.4 Asset impairments (e)———2.5 Other31.931.846.443.5 TSA reimbursement (f)0.522.93.845.3 Adjusted operating income$ 531.6$ 479.9$ 1,000.6$ 932.7Adjusted operating profit margin15.1 %14.9 %14.6 %14.6 %Adjusted Net Income Net income$ 237.9$ 205.3$ 450.7$ 433.3 Impact of adjustments to operating income137.1185.1280.1316.6 Loss on venture fund investments, net (g)32.71.536.15.7 Gain on sale of business (h)———(4.9) TSA reimbursement (f)(0.5)(22.9)(3.8)(45.3) Other 0.70.30.70.3 Income tax impact of adjustments (i)(43.4)(37.3)(75.3)(61.5) Adjusted net income$ 364.5$ 332.0$ 688.5$ 644.2Weighted-average diluted common shares outstanding83.984.384.184.5Adjusted net income per share$ 4.35$ 3.94$ 8.19$ 7.62 (a) Amortization of intangible assets acquired as part of business acquisitions. (b) Restructuring and other charges represent amounts incurred in connection with the elimination of redundant positions and facilities and contract termination costs within the organization in connection with our LaunchPad initiatives, and acquisitions or dispositions of businesses by the company. (c) Acquisition and disposition-related costs include due-diligence legal and advisory fees, retention bonuses, impact of delayed contract or license transfers, and other integration or disposition related activities. (d) LaunchPad costs include non-capitalized costs associated with the implementation of systems, consolidation of processes, and consulting costs incurred as part of various business process improvement initiatives. (e) The company impaired certain fixed assets which are no longer realizable by the business. (f) Represents transition services fees charged to Fortrea Holdings Inc. related to administrative and IT systems support. The costs to provide these services are included in operating income but the service fees are included in other income. (g) The company makes investments in companies or investment funds developing promising technology related to its operations. The company recorded net gains and losses related to several distributions from venture funds, increases in the market value of investments, and impairments of other investments due to the underlying performance of the investments. (h) The company recorded a gain on the disposition of the Beacon Laboratory Benefits Solutions business. (i) Income tax impact of adjustments calculated based on the tax rate applicable to each item. View original content to download multimedia: SOURCE Labcorp Holdings Inc

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