Epidemiology, pathophysiology, and classification of the neurological symptoms of post-COVID-19 syndrome

Abstract

Introduction Post-COVID-19 syndrome is a series of chronic signs and symptoms that may appear after SARS-CoV-2 infection, including fatigue, dyspnoea, chest pain, palpitations, anxiety, depression, and joint and muscle pain. The purpose of this study was to review the controversies on post-COVID-19 syndrome, the frequency of neurological symptoms, and the potential pathophysiological mechanisms. Methods We present a narrative review of studies published in PubMed since the beginning of the pandemic (January 2020–July 2021). Results Patients with history of COVID-19 have been found to present persistent neurological symptoms, including cognitive complaints, memory and concentration problems, headache, anosmia, ageusia, vertigo, and insomnia. Post-COVID-19 syndrome is a heterogeneous disease that lacks a universally accepted definition, which may explain the great variability in the estimated prevalence (2.3%–85%) and symptom duration. The criteria differentiating post-COVID-19 syndrome from chronic fatigue syndrome or critical illness syndrome are ambiguous. Risk factors include older age, female sex, certain comorbidities, and greater number of symptoms in the acute phase. The pathophysiology of the syndrome is largely unknown, although it is probably multifactorial, including immunological mechanisms, neural network dysfunction, neurotransmitter alterations, persistent viral damage, and functional impairment. Conclusions Post-COVID-19 syndrome may present after mild or even asymptomatic SARS-CoV-2 infection, causing limitations in activities of daily living and in quality of life. Further research will clarify the origin and most appropriate management of these neurological alterations.

Carga de enfermedad por COVID-19 en el departamento de Nariño, Colombia, 2020-2021

“…No se tuvieron en cuenta los casos de enfermedad de COVID-19 persistente, síndrome que tiene diversas maneras de presentación, y que afecta tanto pacientes asintomáticos como a hospitalizados, con múltiples sintomatologías, y que requieren un manejo multidisciplinario, lo cual impacta, en muchos casos, la calidad de vida. Puede haber una subestimación del componente de morbilidad AVD, a partir del posible subreporte y de casos leves (42,43) .…”

Long COVID Oral Cavity Symptoms Based on Selected Clinical Cases

“…Severe COVID-19 and hospitalization may prompt the emergence of postintensive care syndrome or posttraumatic stress disorder. 8 9 10 Many oral symptoms have also been reported, such as dryness, follicular lesions, 11 12 13 recurrent ulcerations and erosions, 14 mucositis, 15 exanthema, 16 cheilitis, 17 mycosis 18 aphthous-like changes, 19 pustules, cracked or papillae-free tongue, spots, papules, change in pigmentation, halitosis, leukoplakia, hemorrhagic crusts, ecchymosis, edema, erythema, and spontaneous bleeding. 20 21 22 23…”

Neuropsychiatric post-acute sequelae of COVID-19: prevalence, severity, and impact of vaccination

“…The prevalence of PASC varies greatly between studies, probably reflecting the differences in the definitions of this entity, populations examined, and follow-up durations. According to the literature, 30–80% of convalescent patients are likely to develop one or more PASC [ 30 – 33 ]. Out of the 1638 patients recruited in our study, 598 (36.5%) suffered from neuropsychiatric PASC.…”