|LETTER TO EDITOR
|Year : 2022 | Volume
| Issue : 1 | Page : 74-75
Post-COVID-19 neurological syndrome
Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
Department of Medicine, Federal University of Santa Maria, Santa Maria, Brazil
|Date of Submission||16-Mar-2022|
|Date of Acceptance||25-Apr-2022|
|Date of Web Publication||21-Jul-2022|
Jamir Pitton Rissardo
Av. Roraima, 1000 - Camobi, Santa Maria - RS, 97105-900
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Rissardo JP, Fornari Caprara AL. Post-COVID-19 neurological syndrome. Santosh Univ J Health Sci 2022;8:74-5
We read the manuscript entitled “Assessment of post-COVID 19 symptoms: An observational cohort study from a level 3 COVID hospital” on the esteemed Santosh University Journal of Health Sciences with great interest. Saxena et al. studied the clinical manifestations in 99 individuals who recovered from mild-to-moderate COVID-19 disease. The most common complaints were fatigue, headache, hearing loss, and wheezing. Interestingly, females were significantly more commonly affected by fatigue and muscle weakness.
The mortality rate associated with COVID-19 varies among different countries, which can be attributed, in part, to the median age of the affected population and the availability of critical resources needed to treat the patients. According to many reports, the newly emerging SARS-CoV-2 virus is associated with neurological complications in more than 30% of the patients. These individuals experience a triad of physical, cognitive, and mental issues that can chronically affect their everyday life. Herein, we would like to discuss the long-term brain disorders in post-COVID-19 disease [Figure 1].
The clinical presentation of SARS-CoV-2 infection depends on the severity of the disease and may range from asymptomatic infection to a severe and lethal illness. Al-Ramadan et al. reviewed the literature about postacute neurological manifestations of COVID-19 disease. They observed that the main reported symptoms were fatigue, changes in concentration, loss of memory, and sleep disorders. In the majority of the individuals, these clinical manifestations persisted for more than 6 weeks after the onset of COVID-19. It is worth mentioning that the therapeutic options available to COVID-19 could be possible confounding factors of these chronic symptoms since they have the potential to cause or even worse neurological and psychiatric comorbidities.
Nuzzo et al. hypothesized that the long-term neurological manifestations could be explained by a possible overlap between the pathophysiological pathways of SARS-CoV-2 infection and neurodegenerative diseases. Similar pathological abnormalities encountered in both disorders are mitochondrial dysfunction, inflammation, lysosome damage, and protein aggregation. Interestingly, the overlap is mainly observed in severe manifestations of COVID-19 such as neuropsychiatric diseases, ischemic stroke, and encephalitis. It is noteworthy that a more precise definition of the characteristics of postacute COVID-19 neurological syndrome should be done to identify effective methods of intervention.
Several publications using human brain organoid cultures showed that SARS-CoV-2 can infect neural progenitor cells and neurons with the release of infectious viruses. Thus, the assessment of peripheral biomarkers is essential to predict neurocognitive outcomes. Sun et al. showed a significant relationship between IL-6 and the severity of chronic neurological symptoms. On the other hand, recovery in neuronal-enriched extracellular vesicle patients was associated with amyloid-beta peptide, neurofilament light, neurogranin, total tau, and p-T181-tau levels.
In sum, there are a large number of publications about SARS-CoV-2 neurotropism. However, the etiopathology of neuronal damage is not entirely known. It is mandatory a better clinical definition of the emerging brain disorders in post-COVID-19 syndrome during a long-term follow-up. Further, future studies should evaluate this neuropsychological spectrum with multidisciplinary teams to assess possible diagnostic criteria and specific management.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Saxena P, Chandra E, Sahay S, Mahendran CS, Das P, Jose JV, et al
. Assessment of post-COVID 19 symptoms: An observational cohort study from a level 3 COVID hospital. Santosh Univ J Health Sci 2021;7:15-9. [Full text]
Rissardo JP, Caprara AL. Neurological manifestations of rhino-orbital-cerebral mucormycosis (zygomycosis). J Indira Gandhi Inst Med Sci 2022;8:71-2. [Full text]
Al-Ramadan A, Rabab'h O, Shah J, Gharaibeh A. Acute and post-acute neurological complications of COVID-19. Neurol Int 2021;13:102-19.
Nuzzo D, Vasto S, Scalisi L, Cottone S, Cambula G, Rizzo M, et al.
Post-acute COVID-19 neurological syndrome: A new medical challenge. J Clin Med 2021;10:1947.
Sun B, Tang N, Peluso MJ, Iyer NS, Torres L, Donatelli JL, et al.
Characterization and biomarker analyses of post-COVID-19 complications and neurological manifestations. Cells 2021;10:386.