Post-COVID 19 neurological syndrome: The need to define a cut-off score between the acute and post-COVID 19 phases

Neuropsychiatric phenotype of post-COVID 19 neurological syndrome: broadening the concept

“…The evolution of the COVID-19 pandemic has wreaked havoc in all areas of human development. 1,2 Although it was thought that the first phase of the pandemic was going to be the most critical, the reality seems to be different, and it is that the sequels left by the organic affectation by the same disease of the COVID-19, have caused an elevation in the indicators of global disease burden. 1 Post-COVID-19 syndrome is a recently described entity of which much is still unknown.…”

“…It is defined as the persistence or appearance of symptoms after the acute phase of COVID-19, establishing three cut-off scores, after 21 days (post-COVID acute), between one month and 3 months (post-COVID subacute) and persistence after 3 months (post-COVID chronic); and these symptoms must affect the functional capacity of the individual, which does not allow the adequate development of the activities of daily living. 1,2…”

Letter: Spectrum of hospitalized NeuroCOVID diagnoses from a tertiary care neurology centre in Eastern India

“…The natural history of NeuroCOVID shows that approximately 21 days after the onset of the acute phase of COVID-19 symptoms, the post-COVID-19 phase begins [6] , which, if concentrated in sequelae or new neurological manifestations, is known as post-COVID-19 neurological syndrome [7] , [8] , [9] . It has been described that this is a risk period where the neuroinflammation caused by SARS-Cov-2 remains active and precipitates the development of complications due to neuroimmunological alterations, which may facilitate the appearance of co-infections [7] , [8] , [9] . This correlates with the invasion of fungal agents belonging to the genera Mucor , Absidia and Rhizopus , reported in different parts of the world [10] , [11] , [12] , [13] , which produce mucormycosis; a condition that has a powerful destructive potential [10] .…”

“…Interestingly, however, there are cases reports and case series that show that this condition can develop even in those before 21 days (theoretically during the acute phase of COVID-19) [10] , [11] , [12] , [13] . But it should be clarified that there are still no precise cut-off scores for the time between the acute phase transition and post-COVID phase, which is a potential bias in the characterization of these patients [9] .…”

Acute coronary syndromes following COVID-19 vaccine application: Kounis syndrome or chance?

“…Actually, it cannot be determined with certainty that an acute coronary syndrome following the application of the COVID-19 vaccine corresponds to Kounis syndrome or if it is an incidental event due to subclinical coronary artery disease or decompensation of previous disease. New research on cardiac injury in COVID-19, both in the acute phase and during the post-COVID-19 syndrome, continues to emerge [ [9] , [10] , [11] , [12] ]. Further research is needed to investigate whether there is a possibility of silent myocardial injury [ 12 ], either by administration of vaccine doses or as a mechanism derived from SARS-Cov-2 infection.…”