A review of the sequelae of post Covid-19 with neurological implications (post-viral syndrome), 2025, Struhal

https://www.sciencedirect.com/science/article/abs/pii/S0022510X25001492

Journal of the Neurological Sciences
Available online 12 May 2025, 123532
In Press, Journal Pre-proof

A review of the sequelae of post Covid-19 with neurological implications (post-viral syndrome)

Walter Struhal , Doaa Almamoori
Karl Landsteiner University of Health Sciences, Department of Neurology, University Hospital Tulln, 3430 Tulln, Austria
Received 2 January 2025, Revised 7 April 2025, Accepted 5 May 2025, Available online 12 May 2025.


https://doi.org/10.1016/j.jns.2025.123532Get rights and content

Highlights

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  Examining the various definitions proposed for the post Covid-19 condition
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  Shedding light on the development and the evolution of the pathophysiological hypotheses of post-viral conditions during and after the pandemic
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  The complexity of fatigue and later management and critical look to the diagnostic approach
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  Rare and serious neurological sequelae linked to Post Covid-19 conditions
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  An overview on the current clinical practice for diagnosis and management of Post Covid-19.

Abstract

Post Covid-19 conditions represent a medical challenge; a unified definition is not achieved after 5 years of the Pandemic.

The incidence of Post Covid-19 conditions varies, nevertheless the neurological complications represent an important aspect in the spectrums of fields involved.

The current perception is that varied manifestations and long-term complications of COVID-19 reflect underlying pathophysiological processes, including inflammatory, immune-mediated, and vascular mechanisms. These mechanisms underscore the complexity of COVID-19's impact including the nervous system and its potential for lasting effects.

A number of symptoms are extremely severe and may also need neurologic attention including fatigue, cognitive disturbances, autonomic symptoms, headache, and sleep disorders.

Post Covid-19 conditions are often of chronic nature. Management as in other chronic conditions should rely on the conventional diagnostic measures and management of symptoms irrespective of the temporal relation to the viral infection. To date Post Covid-19 conditions is only accepted as an additional or explanatory diagnosis.