The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 Infection

Jun 28, 2021Current neurology and neuroscience reports

Brain-related symptoms after recovery from COVID-19

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Abstract

Post-acute sequelae of SARS-CoV-2 infection (PASC) may involve neurological manifestations that last for weeks or longer following initial COVID-19 infection.

PASC is recognized as a multi-organ disorder with a wide range of symptoms from mild to incapacitating.
Proposed mechanisms for neurological issues include direct or indirect brain invasion by the virus, immune system abnormalities, and chronic inflammation.
Persistent low-grade infection and damage to other organs could contribute to the development of neurological symptoms in PASC.
A multidisciplinary approach is suggested for effective management, emphasizing tailored rehabilitation and cognitive therapy alongside pharmacological treatments.
There is an urgent need for early identification of individuals suffering from neuro-PASC to ensure appropriate treatment.

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PURPOSE OF REVIEW: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global health challenge. This review aims to summarize the incidence, risk factors, possible pathophysiology, and proposed management of neurological manifestations of post-acute sequelae of SARS-CoV-2 infection (PASC) or neuro-PASC based on the published literature.

RECENT FINDINGS: The National Institutes of Health has noted that PASC is a multi-organ disorder ranging from mild symptoms to an incapacitating state that can last for weeks or longer following recovery from initial infection with SARS-CoV-2. Various pathophysiological mechanisms have been proposed as the culprit for the development of PASC. These include, but are not limited to, direct or indirect invasion of the virus into the brain, immune dysregulation, hormonal disturbances, elevated cytokine levels due to immune reaction leading to chronic inflammation, direct tissue damage to other organs, and persistent low-grade infection. A multidisciplinary approach for the treatment of neuro-PASC will be required to diagnose and address these symptoms. Tailored rehabilitation and novel cognitive therapy protocols are as important as pharmacological treatments to treat neuro-PASC effectively. With recognizing the growing numbers of COVID-19 patients suffering from neuro-PASC, there is an urgent need to identify affected individuals early to provide the most appropriate and efficient treatments. Awareness among the general population and health care professionals about PASC is rising, and more efforts are needed to understand and treat this new emerging challenge. In this review, we summarize the relevant scientific literature about neuro-PASC.

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The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 Infection

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