Neurological manifestations of post-COVID-19 syndrome S1-guideline of the German society of neurology, 2022, Franke et al

Abstract

Infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leads to COVID-19 (COrona VIrus Disease-2019). SARS-CoV-2 acute infection may be associated with an increased incidence of neurological manifestations such as encephalopathy and encephalomyelitis, ischemic stroke and intracerebral hemorrhage, anosmia and neuromuscular diseases. Neurological manifestations are commonly reported during the post-acute phase and are also present in Long-COVID (LCS) and post-COVID-19 syndrome (PCS). In October 2020, the German Society of Neurology (DGN, Deutsche Gesellschaft für Neurologie) published the first guideline on the neurological manifestations of COVID-19. In December 2021 this S1 guideline was revised and guidance for the care of patients with post-COVID-19 syndrome regarding neurological manifestations was added. This is an abbreviated version of the post-COVID-19 syndrome chapter of the guideline issued by the German Neurological society and published in the Guideline repository of the AWMF (Working Group of Scientific Medical Societies; Arbeitsgemeinschaft wissenschaftlicher Medizinischer Fachgesellschaften).

Open access, https://neurolrespract.biomedcentral.com/articles/10.1186/s42466-022-00191-y

 

"To date there are no established and effective medical treatment options for post-viral fatigue and cognitive impairment, as well as related conditions such as myalgic encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS). If there are indications of autoimmunity, therapeutic approaches including corticosteroids, intravenous immunoglobulins or therapeutic apheresis can be administered depending on risk and expected benefit.

A causal therapy for fatigue is unknown. Non-drug therapeutic approaches such as relaxation techniques, moderate physical activity, acquisition of adequate coping behavior strategies in addition to psychotherapeutic or psychopharmacological treatment are recommended."