Neurological post‐acute sequelae of SARS‐CoV‐2 infection

Sep 23, 2022Psychiatry and clinical neurosciences

Long-term nervous system problems after COVID-19 infection

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Abstract

Approximately 50% of patients may show at least one symptom of post-acute sequelae of SARS-CoV-2 infection (PASC) up to 12 months after COVID-19 infection.

PASC symptoms can include fatigue, dyspnea, palpitation, dysosmia, and sleep problems.
Neurological and psychiatric symptoms are part of the wide range of PASC manifestations.
The specific causes of PASC remain unclear, complicating its diagnosis.
No definite diagnostic criteria or treatments for PASC have been established.
The World Health Organization's broad definition of PASC highlights the challenges in identifying the condition.

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The novel coronavirus disease 19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can have two phases: acute (generally 4 weeks after onset) and chronic (>4 weeks after onset). Both phases include a wide variety of signs and symptoms including neurological and psychiatric symptoms. The signs and symptoms that are considered sequelae of COVID-19 are termed post-COVID condition, long COVID-19, and post-acute sequelae of SARS-CoV-2 infection (PASC). PASC symptoms include fatigue, dyspnea, palpitation, dysosmia, subfever, hypertension, alopecia, sleep problems, loss of concentration, amnesia, numbness, pain, gastrointestinal symptoms, depression, and anxiety. Because the specific pathophysiology of PASC has not yet been clarified, there are no definite criteria of the condition, hence the World Health Organization's definition is quite broad. Consequently, it is difficult to correctly diagnose PASC. Approximately 50% of patients may show at least one PASC symptom up to 12 months after COVID-19 infection; however, the exact prevalence of PASC has not been determined. Despite extensive research in progress worldwide, there are currently no clear diagnostic methodologies or treatments for PASC. In this review, we discuss the currently available information on PASC and highlight the neurological sequelae of COVID-19 infection. Furthermore, we provide clinical suggestions for diagnosing and caring for patients with PASC based on our outpatient clinic experience.

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Neurological post‐acute sequelae of SARS‐CoV‐2 infection

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