Neurological sequelae of long COVID: a comprehensive review of diagnostic imaging, underlying mechanisms, and potential therapeutics

Frontiers in Neurology, Journal Year: 2025, Volume and Issue: 15

Published: Feb. 7, 2025

One lingering effect of the COVID-19 pandemic created by SARS-CoV-2 is emergence Long COVID (LC), characterized enduring neurological sequelae affecting a significant portion survivors. This review provides thorough analysis these disruptions with respect to cognitive dysfunction, which broadly manifest as chronic insomnia, fatigue, mood dysregulation, and impairments dysfunction. Furthermore, we characterize how diagnostic tools such PET, MRI, EEG, ultrasonography provide critical insight into subtle anomalies that may mechanistically explain disease phenotype. In this review, explore mechanistic hypotheses changes, describe CNS invasion, neuroinflammation, blood-brain barrier disruption, gut-brain axis along novel vascular disruption hypothesis highlights endothelial dysfunction hypoperfusion core underlying mechanism. We lastly evaluate clinical treatment landscape, scrutinizing efficacy various therapeutic strategies ranging from antivirals anti-inflammatory agents in mitigating multifaceted symptoms LC.

Language: Английский

Cognitive Sequelae of COVID‐19: Mechanistic Insights and Therapeutic Approaches

CNS Neuroscience & Therapeutics, Journal Year: 2025, Volume and Issue: 31(3)

Published: March 1, 2025

ABSTRACT Background The COVID‐19 pandemic has left an indelible mark on the world, with mounting evidence suggesting that it not only posed acute challenges to global healthcare systems but also unveiled a complex array of long‐term consequences, particularly cognitive impairment (CI). As persistence post‐COVID‐19 neurological syndrome could evolve into next public health crisis, is imperative gain better understanding intricate pathophysiology CI in patients and viable treatment strategies. Methods This comprehensive review explores management across phases COVID‐19, from infection Long‐COVID, by synthesizing findings clinical, preclinical, mechanistic studies identify key contributors CI, as well current therapeutic approaches. Results Key mechanisms contributing include persistent neuroinflammation, cerebrovascular complications, direct neuronal injury, activation kynurenine pathway, psychological distress. Both pharmacological interventions, such anti‐inflammatory therapies agents targeting neuroinflammatory pathways, non‐pharmacological strategies, including rehabilitation, show promise addressing these challenges. Although much derived preclinical animal studies, provide foundational insights potential Conclusion By knowledge, this highlights importance COVID‐19‐related offers actionable for mitigation recovery community continues grapple pandemic's impact.

Language: Английский

Successful treatment with guanfacine in a long‐COVID case manifesting marked cognitive impairment

Neuropsychopharmacology Reports, Journal Year: 2024, Volume and Issue: 44(3), P. 585 - 590

Published: June 27, 2024

Abstract Background Persistent cognitive impairment is a serious consequence of the post‐COVID condition. However, there have been no established effective treatments for this pathophysiology supported by sufficient evidence. Case Presentation A 32‐year‐old woman became aware difficulty in word recalling, reading, and writing as well completing various household multitasks 3 weeks after COVID‐19 infection. Although blood tests, magnetic resonance imaging, electroencephalography, Kohs block design test were all within normal limits, completion time trail making (TMT) or B was markedly delayed. Finally, she referred to our hospital months At baseline, THINC integrated tool (THINC‐it), digital battery consisting five‐item version perceived deficit questionnaire (PDQ‐5), choice reaction (CRT), 1‐back test, digit symbol substitution (DSST), TMT‐B, revealed poor capability attention, working memory, executive function. Also, near‐infrared spectroscopy (NIRS) demonstrated activation frontal temporal regions during verbal fluency task. Extended‐release guanfacine (GXR) 2 mg/day initiated month later elevated up 4 maintenance dose. The PDQ‐5, CRT, DSST, TMT‐B dramatically improved 1 GXR treatment. NIRS finding also normalized These effects successfully maintained throughout 6‐month follow‐up period. Conclusion may be helpful improving subjective/objective functioning frontotemporal brain activity long‐COVID patients manifesting apparent impairment.

Language: Английский