Analysis of Risk Factors for Neurological Complications of SARS-Cov-2 Infection: Focus on Chronic Fatigability, 2025, Diaconu et al

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Med. Surg. J. – Rev. Med. Chir. Soc. Med. Nat., Iaşi 2025, 129(4): 642-649 doi: 10.22551/MSJ.2025.04.03
INTERNAL MEDICINE - PEDIATRICS ORIGINAL PAPERS
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ANALYSIS OF RISK FACTORS FOR NEUROLOGICAL COMPLICATIONS OF SARS-COV-2 INFECTION: FOCUS ON CHRONIC FATIGABILITY

Iulia Elena Diaconu1, Maria Ioana Onofrei1,2*, A. Vȃţă1,2, Raluca Erika Irimie Baluta1,2, A. N. Avadanei2,3, Ioana Alina Harja-Alexa1,2, Mihaela Catalina Luca1,2

1. Grigore T. Popa University of Medicine and Pharmacy Iasi 2. Sf. Parascheva Clinical Hospital of Infectious Diseases Iasi 3. Sf. Spiridon County Clinical Emergency Hospital Iasi *Corresponding author. E-mail: maria-ioana.hunea@umfiasi.ro

ANALYSIS OF RISK FACTORS FOR NEUROLOGICAL COMPLICATIONS OF SARS-COV-2 INFECTION: FOCUS ON CHRONIC FATIGABILITY

(Abstract):

Aim:

Chronic fa-tigue syndrome is a long-term neurological manifestation that significantly affects the quality of life of patients. Its etiology is incompletely known, although it can occur after various infections including COVID-19, and the associated risk factors are not fully defined. The aim of the current study was to evaluate neurological manifestations in long-COVID and to identify potential risk factors for these complications.

Materials and methods:

We performed retro - prospective study on patients with history of COVID-19 infections. Patients were assessed up to 3 years after infection. Clinical and neurological investigations, brain imaging, analysis of inflammatory markers, levels of vitamin B12, folic acid and vitamin D were carried out. Neurocognitive status was assessed using a validated semiquantitative scale.

Results:

In 132 eligible patients, 41.67% of cases developed chronic fatigability. Oth-er neurological manifestations associated with Long-COVID were dizziness (29.17% cases), and memory impairment (25% cases). The deterioration of the neurocognitive status 1 year after infection was significantly correlated with the patient’s age (p<0,0001), serum vitamin D (p=0.015), as well as vitamin B12 (p=0.006).

Conclusions:

Chronic fatigability is a com-mon neurological complication of COVID-19 infection. Older people, those with low vita-min D and vitamin B12 levels, have higher risk of developing this syndrome. The COVID-19 infected patients need multiple investigations and a multidisciplinary approach to prevent these long-term complications.

Keywords: RISK FACTORS, NEUROLOGICAL COMPLI-CATIONS, SARS-COV-2, INFECTION, FATIGABILITY.
 
By this point we probably crossed the hundred studies like this on LC. Not a single one has found anything useful, not even a single bit of useful information, and it doesn't seem like anyone is bothered by that, they just keep coming, always looking at the same basic data with a slightly different lens.

There seems to be an inability to accept that some problems are just probabilistic, there is no way to reliably predict any of it, at most there is a slight variation in risk factor but nothing that matters for any individual case. It seems instead rather like MS, where the only necessary factor is mono, the rest is completely hidden, and likely rests entirely on chance, on virion particle getting to where they should not go, which starts various possible cascades of which about the only visible impact is lesions on MRIs and whatever it is they can see analyzing spinal fluid.
The paper said:
Older people, those with low vita-min D and vitamin B12 levels, have higher risk of developing this syndrome. The COVID-19 infected patients need multiple investigations and a multidisciplinary approach to prevent these long-term complications.
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The first sentence is obviously useless for the most part, as those low levels are common and are not reasonably modifiable, it's not as if the whole population monitoring their levels of vitamins and keeping within some range would have any effect on outcomes, while age is inevitable so whatever. The second sentence is, as @Eleanor says, delusional. Obviously no such thing exists, especially the multidisciplinary approach. It's not even speculative at this point, it's straight up false, there is no such thing and never will be.

Because even if it were true, it would never happen. Rehabilitation of this type is the least scalable and most expensive way treating people, it's fully linear and actually has negative economy of scale, as bigger systems featuring more employees always need a larger bureaucracy, while everything is thought around the fully artificial context of small independent teams doing whatever they feel like doing and reporting that, heh, it probably works, because they want it to. It's even more expensive than even the most expensive drugs since the cost of those drugs is always based on patents, and those expire, while a system built around such multidisciplinary team has zero room to increase in efficiency.

There will never be enough therapists to sustain such an approach. Even the very best, most promising results barely show a slight positive uptick in a small subset, so roughly 90% of those resources would be entirely wasted, and the remaining 10% doesn't even swing any needle.

This whole approach where there is zero coordination, zero leveraging or pooling of resources, basically the equivalent of a search-and-rescue operation without any coordination, has proven to be completely useless. It would be easy to dismiss this study because it's from Romania, but nothing anywhere else has been any better, any more coherent or is any more useful. A system that keeps doing, poorly, the same thing in circles, never changing a damn thing no matter how obviously it fails.
 
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