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[Long COVID: Pathogenesis and Therapeutic Approach]
Hirohisa Watanabe1, Sayuri Shima, Yasuaki Mizutani
1Department of Neurology, Fujita Health University, School of Medicine, Department of Neurology.
Brain and Nerve = Shinkei Kenkyu No Shinpo
|July 21, 2022
Summary
Long COVID causes persistent systemic and neurological symptoms like brain fog and cognitive decline. Potential causes include persistent inflammation, autoimmune issues, and mitochondrial dysfunction, impacting brain function long after infection.
Area of Science:
- Neurology
- Immunology
- Infectious Diseases
Background:
- Coronavirus disease 2019 (COVID-19) can lead to persistent systemic symptoms post-infection.
- These long-term symptoms include neurological issues such as cognitive decline, brain fog, and autonomic dysfunction.
- Imaging studies reveal decreased brain glucose metabolism and atrophy in long COVID patients.
Purpose of the Study:
- To summarize the persistent neurological symptoms observed in long COVID.
- To explore the proposed pathophysiological mechanisms underlying long COVID.
- To highlight the need for understanding the complex pathophysiology of long COVID.
Main Methods:
- Review of clinical observations of persistent symptoms post-COVID-19.
- Analysis of findings from neuroimaging studies in long COVID cases.
- Synthesis of current hypotheses on COVID-19 pathophysiology.
Main Results:
- Long COVID patients present with diverse persistent symptoms including psychiatric, sleep, exercise intolerance, arthralgia, headache, cognitive, brain fog, and autonomic issues.
- Hypotheses for pathophysiology include persistent viral infection, inflammation, autoimmunity, and mitochondrial dysfunction.
- Inflammatory cytokines and autoantibodies are implicated in neurological and autonomic dysregulation.
Conclusions:
- The pathophysiology of long COVID is complex and multifactorial, with no single unifying explanation.
- Understanding the neurological manifestations and underlying mechanisms is crucial for managing long COVID.
- Further research is needed to establish a definitive consensus on long COVID's diverse presentations.
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