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

Moghimi, Narges; Napoli, Mario Di; Biller, José; Siegler, James E.; Shekhar, Rahul; McCullough, Louise D.; Harkins, Michelle; Hong, Emily; Alaouieh, Danielle; Mansueto, Gelsomina; Divani, Afshin A.

doi:10.1007/s11910-021-01130-1

Cited by 150 publications

(137 citation statements)

References 153 publications

(166 reference statements)

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“…Symptom burden appears to be independent of the severity of initial infection, with no clear predictors of who will develop ongoing symptoms [10]. Persistent endothelial dysfunction may be responsible for the wide variation in symptoms reported [11][12][13]. There is also some evidence suggesting that altered inflammatory cytokine pathways may persist during convalescence [14].…”

Section: Introductionmentioning

confidence: 99%

Investigating the Relationship between Vitamin D and Persistent Symptoms Following SARS-CoV-2 Infection

et al. 2021

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The emergence of persistent symptoms following SARS-CoV-2 infection, known as long COVID, is providing a new challenge to healthcare systems. The cardinal features are fatigue and reduced exercise tolerance. Vitamin D is known to have pleotropic effects far beyond bone health and is associated with immune modulation and autoimmunity. We hypothesize that vitamin D levels are associated with persistent symptoms following COVID-19. Herein, we investigate the relationship between vitamin D and fatigue and reduced exercise tolerance, assessed by the Chalder Fatigue Score, six-minute walk test and modified Borg scale. Multivariable linear and logistic regression models were used to evaluate the relationships. A total of 149 patients were recruited at a median of 79 days after COVID-19 illness. The median vitamin D level was 62 nmol/L, with n = 36 (24%) having levels 30–49 nmol/L and n = 14 (9%) with levels <30 nmol/L. Fatigue was common, with n = 86 (58%) meeting the case definition. The median Borg score was 3, while the median distance covered for the walk test was 450 m. No relationship between vitamin D and the measures of ongoing ill-health assessed in the study was found following multivariable regression analysis. These results suggest that persistent fatigue and reduced exercise tolerance following COVID-19 are independent of vitamin D.

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Section: Introductionmentioning

confidence: 99%

Investigating the Relationship between Vitamin D and Persistent Symptoms Following SARS-CoV-2 Infection

et al. 2021

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“…Scientific evidence of the persistence of neurological symptoms following acute COVID-19 is increasing. It is a process recently termed Neuro-PASC (neurological manifestations of post-acute sequelae of SARS-CoV-2 infection) [20]. Numerous COVID-19 patients suffer from PASC, with the number of cases severely increasing as more people are infected [21].…”

Section: Introductionmentioning

confidence: 99%

18F-FDG-PET Imaging for Post-COVID-19 Brain and Skeletal Muscle Alterations

Rudroff

Workman

Ponto

2021

Viruses

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Scientific evidence concerning the subacute and long-term effects of coronavirus disease 2019 (COVID-19) is on the rise. It has been established that infection by serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a systemic process that involves multiple organs. The complications and long-term consequences of COVID-19 are diverse and patients need a multidisciplinary treatment approach in the acute and post-acute stages of the disease. A significant proportion of COVID-19 patients experience neurological manifestations, some enduring for several months post-recovery. However, brain and skeletal muscle changes resultant from SARS CoV-2 infection remain largely unknown. Here, we provide a brief overview of the current knowledge, and usefulness, of [18F]fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG-PET/CT) to investigate brain and skeletal muscles changes in Post-COVID-19 patients with persistent symptoms. Furthermore, a brief discussion of future 18F-FDG-PET/CT applications that might advance the current knowledge of the pathogenesis of post-COVID-19 is also provided.

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“…During the COVID-19 pandemic, this term has been used to describe difficulty concentrating, memory problems, and sometimes confusion, ( 15 , 16 ) hypersensitivity to light and sound, and tinnitus. ( 17 ) Together with fatigue, cognitive symptoms frequently persist beyond 4 weeks after SARS-CoV-2 infection. They often copresent with mood disorders such as anxiety, emotional lability, and dysphoria.…”

Section: Brain Fog and Cognitive Impairmentmentioning

confidence: 99%

Cognitive symptoms after COVID-19

Altuna

Sánchez-Saudinós

Lleó

2021

Neurology Perspectives

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Introduction SARS-CoV-2 infection frequently causes neurological symptoms. Cognitive alterations are among the most frequent symptoms, and may persist beyond the acute phase of infection. Methods We conducted a narrative review of the literature. Results Hospitalised patients, and especially critically ill patients, are at greater risk of developing cognitive symptoms. Post–COVID-19 cognitive symptoms, unlike those associated with other viral illnesses, have been observed in patients with mild infection, and present some atypical features. Cognitive symptoms may last longer in COVID-19 than in other infectious processes, and more frequently affect young people. Post–COVID-19 cognitive symptoms share common features with those described in chronic fatigue syndrome, including a similar profile with affective symptoms. Brief screening tests for cognitive impairment present suboptimal diagnostic performance, and standardised criteria are needed to ensure correct diagnosis. Post–COVID-19 cognitive impairment can have a significant impact on the patient's quality of life and functional independence, regardless of other post–COVID-19 symptoms. Currently, no specific treatments have been approved for post–COVID-19 cognitive impairment, although cognitive stimulation may be useful in some patients. Conclusions Post–COVID-19 cognitive symptoms are common and are often associated with other systemic symptoms. Neuropsychological evaluation may be useful for diagnosis and to quantify their severity and long-term prognosis. Detailed, and individualised assessment of cognitive impairment may enable the design of treatment plans.

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

Cited by 150 publications

References 153 publications

Investigating the Relationship between Vitamin D and Persistent Symptoms Following SARS-CoV-2 Infection

Investigating the Relationship between Vitamin D and Persistent Symptoms Following SARS-CoV-2 Infection

18F-FDG-PET Imaging for Post-COVID-19 Brain and Skeletal Muscle Alterations

Cognitive symptoms after COVID-19

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