Specialist care at a distance: Patient-reported experience with telemedicine video consultations for neurological symptoms associated with post-COVID-19 condition or in temporal association with COVID-19 vaccination in a single-center retrospective cross-sectional study

Objectives To describe patient-reported experience with a structured telemedicine video consultation (TVC) pathway in routine neurological care among adults with persistent neurological symptoms with onset after SARS-CoV-2 infection or in temporal association with COVID-19 vaccination. Methods This single-center retrospective cross-sectional study examined TVC delivered in routine clinical care at the Department of Neurology, Charité-Universitätsmedizin Berlin (11/2022–12/2023). Patients with neurological symptoms persisting ≥3 months after SARS-CoV-2 infection or occurring in temporal association with COVID-19 vaccination were included. Data included demographics, symptom assessments, validated questionnaires on mood, fatigue, and subjective memory, audiovisual cognitive screening, and a post-consultation survey of patient-reported telemedicine experience. Results Forty-one patients (mean age 41.3±12.8 years; 61% female) were included. The median home-to-clinic distance was 356 km; and 39% reported mobility limitations affecting in-person attendance. Patients reported positive immediate experiences: most found scheduling easy, reported good audio/video quality, and considered the consultation relevant and time-saving. A minority reported technical difficulties or required assistance. Patients reported high fatigue levels (Fatigue Severity Scale 5.3±1.8), frequent subjective cognitive symptoms, moderate subjective memory satisfaction (Multifactorial Memory Questionnaire-Satisfaction Domain, 47.7±17.3), and mean Montreal Cognitive Assessment score of 27.3±2.3. Discussion These exploratory findings indicate positive patient-reported experience with a structured TVC pathway in routine neurological care. Fatigue and subjective cognitive difficulties were common across the selected cohort. This study describes a tele-neurology workflow integrating document pre-review, digital symptom assessment, remote history taking, and cognitive screening. Further controlled longitudinal studies are needed to determine the clinical role, safety, and equitable implementation of such approaches.