Chronic and delayed neurological manifestations of persistent infections 2023, Pandya & Johnson

Abstract
Purpose of the review

Persistent infections capable of causing central nervous system (CNS) complications months or years after the initial infection represent a major public health concern. This concern is particularly relevant considering the ongoing coronavirus disease 2019 pandemic, where the long-term neurological effects are still being recognized.

Recent findings
Viral infections are a risk factor for the development of neurodegenerative diseases. In this paper, we provide an in-depth exploration of the prevalent known and suspected persistent pathogens and their epidemiological and mechanistic links to later development of CNS disease. We examine the pathogenic mechanisms involved, including direct viral damage and indirect immune dysregulation, while also addressing the challenges associated with detecting persistent pathogens.

Summary
Viral encephalitis has been closely associated with the later development of neurodegenerative diseases and persistent viral infections of the CNS can result in severe and debilitating symptoms. Further, persistent infections may result in the development of autoreactive lymphocytes and autoimmune mediated tissue damage. Diagnosis of persistent viral infections of the CNS remains challenging and treatment options are limited. The development of additional testing modalities as well as novel antiviral agents and vaccines against these persistent infections remains a crucial research goal.

KEY POINTS

• Viral infections and viral encephalitis are important risk factors for the development of neurodegenerative diseases
• Diagnosing persistent infections within the CNS remains challenging
• Neurologic complications are common features of post-acute infection syndromes
• Multiple disease mechanisms including direct viral damage and continued immune system stimulation contribute to later CNS disease development
  
  
  https://journals.lww.com/co-neurolo...elayed_neurological_manifestations_of.63.aspx