Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom.
Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Brain Connect. 2023 May;13(4):178-210. doi: 10.1089/brain.2022.0058. Epub 2023 Mar 24.
The emergence of COVID-19 was rapidly followed by infection and the deaths of millions of people across the globe. With much of the research and scientific advancement rightly focused on reducing the burden of severe and critical acute COVID-19 infection, the long-term effects endured by those who survived the acute infection has been previously overlooked. Now, an appreciation for the post-COVID-19 condition, including its neurological manifestations, is growing, although there remain many unknowns regarding the etiology and risk factors of the condition, as well as how to effectively diagnose and treat it. Here, drawing upon the experiences and expertise of the clinicians and academics of the European working group on COVID-19, we have reviewed the current literature to provide a comprehensive overview of the neurological sequalae of the post-COVID-19 condition. In this review, we provide a summary of the neurological symptoms associated with the post-COVID-19 condition, before discussing the possible mechanisms which may underly and manifest these symptoms. Following this, we explore the risk factors for developing neurological symptoms as a result of COVID-19 and the post-COVID-19 condition, as well as how COVID-19 infection may itself be a risk factor for the development of neurological disease in the future. Lastly, we evaluate how the post-COVID condition could be accurately diagnosed and effectively treated, including examples of the current guidelines, clinical outcomes, and tools that have been developed to aid in this process, as well as addressing the protection provided by COVID-19 vaccines against the post-COVID-19 condition. Overall, this review provides a comprehensive overview of the neurological sequalae of the post-COVID-19 condition. Impact statement With our understanding of the neurological complications of the post-COVID-19 condition currently lacking sufficient depth, this review aimed at highlighting the current knowns and unknowns of the post-COVID-19 condition. In this review, we draw upon the experiences and expertise of the clinicians and academics of the European working group on COVID-19, as well as explore the current published literature, to evaluate a range of topics associated with the neurological complications of the post-COVID-19 condition. As a result, we have provided a comprehensive review of the topic. The European Working Group on SARS-CoV-2 Many essential questions surrounding COVID-19 remain unanswered, including its neurological complications and associated sequalae. In this review, we aim at identifying the current gaps in our understanding of post-COVID-19 neurological sequalae and suggest how future studies should be undertaken to fill these gaps. This review will draw upon the current biological and mechanistic understanding of COVID-19 and post-COVID-19 complications to discuss the clinically relevant aspects associated with the neurological manifestations of post-COVID-19 syndrome. From our discussions, the following questions were considered highly relevant for contemplation.
COVID-19 的出现迅速导致了数百万人在全球范围内感染和死亡。由于大部分研究和科学进步都集中在减轻严重和危急急性 COVID-19 感染的负担上，因此以前忽视了那些从急性感染中幸存下来的人的长期影响。现在，人们对 COVID-19 后疾病的认识，包括其神经表现，正在增加，尽管对于这种疾病的病因和危险因素以及如何有效诊断和治疗，仍然存在许多未知因素。在这里，我们借鉴了欧洲 COVID-19 工作组的临床医生和学者的经验和专业知识，对现有文献进行了综述，提供了 COVID-19 后疾病的神经后遗症的全面概述。在这篇综述中，我们首先总结了与 COVID-19 后疾病相关的神经症状，然后讨论了可能导致这些症状出现和表现的潜在机制。接下来，我们探讨了因 COVID-19 而出现神经症状的风险因素，以及 COVID-19 感染本身如何成为未来发展为神经疾病的风险因素。最后，我们评估了如何准确诊断和有效治疗 COVID-19 后疾病，包括当前指南的例子、临床结果以及为此目的而开发的工具，并讨论了 COVID-19 疫苗对 COVID-19 后疾病的保护作用。总的来说，这篇综述提供了 COVID-19 后疾病的神经后遗症的全面概述。
