Chronic long‐COVID syndrome: A protracted COVID‐19 illness with neurological dysfunctions

Abstract

Long-COVID syndrome is a complex chronic clinical manifestation of signs and symptoms in patients who have experienced the SARS-CoV-2 infection without complete recovery from the COVID-19.A growing fraction of the COVID-19 patients are emerging with continuing effects of the disease, with complaints like mental fog, delayed latent periods in recalling events of the recent past, tachycardia, and extreme fatigue. 1 In the case where Long-COVID syndrome is not observed after SARS-CoV-2 infections, patients have been reported to turn asymptomatic before or within 8-12 weeks after COVID-19. There have been attempts to draw a timeline for Long-COVID and clinical findings persisting beyond 3 weeks after the acute short phase was recommended to be considered for Long-COVID syndrome 2 though cases are appearing even 3 months after the acute phase of COVID-19. | NEUROLOG IC AL DYS FUN C TIONS IN LONG -COVIDInfections caused by SARS-CoV-2 have not only resulted in a gigantic number of morbidities and mortalities worldwide in COVID-19, but its ability to cause a protracted illness in form of long-COVID is now becoming increasingly evident. 2 The syndromic manifestation in long-COVID has shown to become chronic and the affected individuals are seen to be predominately exhibiting neurological deficits which are worrying. The most daunting task in long-COVID is to understand the mechanisms underlying mechanism in general and the pathogenesis of neurological signs and symptoms in particular. Debated here are local routes and systemic mechanisms by which SARS-CoV-2 can involve the nervous system to evoke a low-grade smoldering neuronal injury that possibly contributes to the neurological deficits reported. A better understanding of the route and pathways of the SARS-CoV-2 in the causation of the neurological deficits is expected to develop targeted

Issues related to post-COVID-19 syndrome

“…The nasal and oral cavities provide an area for seeding of SARS-CoV-2. From the olfactory mucosa via retrograde neuronal transport, the virus reaches the central nervous system[ 77 ]. The inflammatory response of nasal and oral mucosa may be the reason for anosmia and hypogeusia.…”

“…The inflammatory response of nasal and oral mucosa may be the reason for anosmia and hypogeusia. Moreover, as anosmia and hypogeusia have a similar mechanism, underlying low-grade inflammation of the frontal lobe might be the cause of the loss of cognition, brain fog, and headache[ 77 ]. As silent target organ damage and underdiagnosis of post-COVID syndrome results in neurological manifestations, taking precautions with regard to initial neurorehabilitation is essential[ 78 ].…”

Mobile primary healthcare for post-COVID patients in rural areas: a proof-of-concept study

“…Because post-COVID syndrome is a novel diagnosis, its full nature, frequency, and etiology remain poorly characterized [ 1 ]. At this time, post-COVID syndrome is broadly defined as the persistence of physical and/or neuropsychological symptoms following recovery from a confirmed or highly probable SARS-CoV-2 infection [ 2 ]. A recent report from the World Health Organization (WHO) that utilized Delphi methodology defined post-COVID syndrome as a set of symptoms exhibited by individuals with a history of probable or confirmed SARS-CoV-2 infection that emerge within 3 months of the onset of acute infection and persist for at least 2 months thereafter that cannot be explained by an alternative diagnosis.…”

Mobile Primary Healthcare for post-COVID Patients in Rural Areas: a Proof-of-Concept Study

“…1 At this time, post-COVID syndrome is broadly defined as the persistence of physical and/or neuro-psychological symptoms following recovery from a confirmed or highly probable SARS-CoV-2 infection. 2 A recent report from the World Health Organization (WHO) that utilized Delphi methodology defined post-COVID syndrome as a set of symptoms exhibited by individuals with a history of probable or confirmed SARS-CoV-2 infection that emerge within three months of the onset of acute infection and persist for at least two months thereafter that cannot be explained by an alternative diagnosis. Most importantly, the WHO Delphi panel stressed that these symptoms must be severe enough to have an impact on everyday functioning.…”