Abstract Accumulating evidence points toward a very high prevalence of prolonged neurological symptoms among coronavirus disease 2019 (COVID-19) survivors. To date, there are no solidified criteria for ‘long-COVID’ diagnosis. Nevertheless, ‘long-COVID’ is conceptualized as a multi-organ disorder with a wide spectrum of clinical manifestations that may be indicative of underlying pulmonary, cardiovascular, endocrine, hematologic, renal, gastrointestinal, dermatologic, immunological, psychiatric, or neurological disease. Involvement of the central or peripheral nervous system is noted in more than one-third of patients with antecedent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, while an approximately threefold higher incidence of neurological symptoms is recorded in observational studies including patient-reported data. The most frequent neurological manifestations of ‘long-COVID’ encompass fatigue; ‘brain fog’; headache; cognitive impairment; sleep, mood, smell, or taste disorders; myalgias; sensorimotor deficits; and dysautonomia. Although very limited evidence exists to date on the pathophysiological mechanisms implicated in the manifestation of ‘long-COVID’, neuroinflammatory and oxidative stress processes are thought to prevail in propagating neurological ‘long-COVID’ sequelae. In this narrative review, we sought to present a comprehensive overview of our current understanding of clinical features, risk factors, and pathophysiological processes of neurological ‘long-COVID’ sequelae. Moreover, we propose diagnostic and therapeutic algorithms that may aid in the prompt recognition and management of underlying causes of neurological symptoms that persist beyond the resolution of acute COVID-19. Furthermore, as causal treatments for ‘long-COVID’ are currently unavailable, we propose therapeutic approaches for symptom-oriented management of neurological ‘long-COVID’ symptoms. In addition, we emphasize that collaborative research initiatives are urgently needed to expedite the development of preventive and therapeutic strategies for neurological ‘long-COVID’ sequelae. Open access, https://journals.sagepub.com/doi/10.1177/20406223221076890
I’m looking at the diagnostic algorithm (screenshot attached) and trying to work out their thinking. I’m not sure I understand the last two boxes just above the MECFS/POTS. It looks like if you have been in ICU or have organ system pathology or autoimmune issues then LC. If the above not fulfilled then it’s LC and you get neurological rehabilitation and psychological intervention. If not a diagnosis of MECFS/POTS but it’s not LC even if Covid caused it?
"Consider overlap with two heavily discriminated diagnoses that the vast majority of physicians either mock or disbelieve". And when they don't they either don't know how to deal with it, or were trained wrong on purpose. Yeah that should do it. If they're serious about this they need to be serious about the fact that this simply doesn't work in real life, that physicians can't consider overlap with discriminated diagnoses that they don't take seriously without addressing the fact that... they don't take it seriously. This is equivalent to saying that poor people should just buy more money, problem solved. Medicine deals just as poorly with uncomfortable truths as anyone does. Ugh. Traditions and myths act as some sort of subservience to hot air, cowering before mindless vague nonsense.
