Neurological and Psychiatric Symptoms of COVID-19: A Narrative Review

Abstract

Recently dubbed Long COVID or Long-Haul COVID, those recovering from the initial COVID-19 infection may maintain clinical signs for longer than two or more weeks following the initial onset of the infection. The virus can gain entry into the CNS through axonal transport mediated through the olfactory nerve or hematogenous spread and can also cross the blood–brain barrier to access the temporal lobe and the brainstem. The neurologic and neuropsychiatric symptoms associated with COVID-19 patients are becoming a highly studied area due to the increased frequency of reported cases. Multiple hospital case series and observational studies have found a headache to be a common symptom among patients who are symptomatic with the SARS-CoV-2 virus. The headache described by many of these patients is similar to new daily persistent headache (NDPH). NDPH potentially develops in response to pro-inflammatory cytokines during a persistent systemic or CNS inflammation, mostly due to the initial infection. The treatments investigated were high-dose steroids, tetracycline derivatives, onabotulinum toxin type A, and long-term multidrug regimens. Among the identified symptoms of post-COVID-19 viral illness, fatigue appears to be the most ubiquitous. High-dose vitamin C is currently a suggested therapy proposed for its antioxidant, anti-inflammatory, and immunomodulatory properties. The mental health consequences of this diagnosis are being identified among large portions of COVID-19 survivors. Among these consequences, cases of major depressive disorder (MDD) and anxiety are being reported and closely examined. The aim of this narrative review is to highlight the neurological and psychiatric symptoms that have been associated with Long-Haul COVID and their possible treatments.

Potential of Nano-Antioxidants and Nanomedicine for Recovery from Neurological Disorders Linked to Long COVID Syndrome

“…Several reports affirmed that many patients who survived the COVID-19 illness continue to exhibit neurological COVID symptoms and fail to revert to their regular daily routines [3][4][5]. Such a post-COVID-19 condition has been classified as "long COVID", "long-haul COVID", "post-acute COVID syndrome", "chronic COVID", and post-acute sequelae of SARS-CoV-2 (PASC) [5][6][7][8][9][10][11][12]. It has been admonished that "long COVID could be the next public health disaster in the making" [13].…”

Ginkgo Biloba and Long COVID: In Vivo and In Vitro Models for the Evaluation of Nanotherapeutic Efficacy

“…Long COVID involves continuous, long-term manifestations of the residual damages and sequelae of coronavirus infection caused by human severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a large positive-stranded enveloped RNA virus that generally provokes respiratory diseases [ 1 , 2 ]. SARS-CoV-2 predominantly affects the respiratory system but can also invade the nervous system and cause multiple neurological disorders [ 3 , 4 , 5 ]. Patients at risk following COVID-19 infection may still exhibit a range of long-term neurologic and psychiatric disorders ( Figure 1 ) and may not fully recover several months post-infection.…”

“…Patients at risk following COVID-19 infection may still exhibit a range of long-term neurologic and psychiatric disorders ( Figure 1 ) and may not fully recover several months post-infection. These sequelae include mild symptoms, such as headaches; extreme tiredness (fatigue); loss of smell, taste, or tactile sensing functions; cognitive impairment; depression; delirium; and psychosis [ 5 ]. More severe documented outcomes include cases of encephalitis, Guillain–Barre syndrome, and stroke [ 5 ].…”

“…These sequelae include mild symptoms, such as headaches; extreme tiredness (fatigue); loss of smell, taste, or tactile sensing functions; cognitive impairment; depression; delirium; and psychosis [ 5 ]. More severe documented outcomes include cases of encephalitis, Guillain–Barre syndrome, and stroke [ 5 ]. These long-term neurological problems following SARS-CoV-2 infection have been described as manifestations of post-COVID-19 syndrome, long COVID, long haulers, or the post-acute sequelae of SARS-CoV-2 (PASC) [ 6 , 7 ].…”

“…Pharmaceutics 2023, 15, x FOR PEER REVIEW 2 of 37 include cases of encephalitis, Guillain-Barre syndrome, and stroke [5]. These long-term neurological problems following SARS-CoV-2 infection have been described as manifestations of post-COVID-19 syndrome, long COVID, long haulers, or the post-acute sequelae of SARS-CoV-2 (PASC) [6,7].…”