Department of Neurology, School of Medicine, 1 University of New Mexico, MSC10-5620, Albuquerque, NM, 87131, USA.
Neurological Service, SS Annunziata Hospital, Sulmona, L'Aquila, Italy.
Curr Neurol Neurosci Rep. 2021 Jun 28;21(9):44. doi: 10.1007/s11910-021-01130-1.
PURPOSE OF REVIEW: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global health challenge. This review aims to summarize the incidence, risk factors, possible pathophysiology, and proposed management of neurological manifestations of post-acute sequelae of SARS-CoV-2 infection (PASC) or neuro-PASC based on the published literature. RECENT FINDINGS: The National Institutes of Health has noted that PASC is a multi-organ disorder ranging from mild symptoms to an incapacitating state that can last for weeks or longer following recovery from initial infection with SARS-CoV-2. Various pathophysiological mechanisms have been proposed as the culprit for the development of PASC. These include, but are not limited to, direct or indirect invasion of the virus into the brain, immune dysregulation, hormonal disturbances, elevated cytokine levels due to immune reaction leading to chronic inflammation, direct tissue damage to other organs, and persistent low-grade infection. A multidisciplinary approach for the treatment of neuro-PASC will be required to diagnose and address these symptoms. Tailored rehabilitation and novel cognitive therapy protocols are as important as pharmacological treatments to treat neuro-PASC effectively. With recognizing the growing numbers of COVID-19 patients suffering from neuro-PASC, there is an urgent need to identify affected individuals early to provide the most appropriate and efficient treatments. Awareness among the general population and health care professionals about PASC is rising, and more efforts are needed to understand and treat this new emerging challenge. In this review, we summarize the relevant scientific literature about neuro-PASC.
目的综述:由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的 2019 年冠状病毒病(COVID-19)是一项全球性的健康挑战。本综述旨在根据已发表的文献,总结 SARS-CoV-2 感染后急性后遗症(PASC)或神经 PASC 的神经系统表现的发生率、危险因素、可能的病理生理学和提出的管理方法。
最新发现:美国国立卫生研究院指出,PASC 是一种多器官疾病,范围从轻度症状到初始 SARS-CoV-2 感染康复后数周或更长时间的致残状态。已经提出了各种病理生理学机制作为 PASC 发展的罪魁祸首。这些机制包括但不限于病毒直接或间接侵犯大脑、免疫失调、激素紊乱、免疫反应导致的细胞因子水平升高引起的慢性炎症、对其他器官的直接组织损伤以及持续的低度感染。需要采用多学科方法来治疗神经 PASC,以诊断和解决这些症状。量身定制的康复和新型认知疗法与药物治疗一样重要,是有效治疗神经 PASC 的关键。鉴于越来越多的 COVID-19 患者患有神经 PASC,因此需要及早识别受影响的个体,以提供最合适和最有效的治疗。普通民众和医疗保健专业人员对 PASC 的认识正在提高,需要付出更多努力来理解和应对这一新出现的挑战。在本综述中,我们总结了有关神经 PASC 的相关科学文献。
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