Neuroprotective Agents with Therapeutic Potential for COVID-19

Zaa, César A.; Espitia, Clara; Reyes-Barrera, Karen L.; An, Zhiqiang; Velasco-Velázquez, Marco A.

doi:10.3390/biom13111585

Cited by 3 publications

(3 citation statements)

References 271 publications

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“…EGb 761 ® was shown to display multimodal effects on a variety of pathogenetic processes which may be involved in PCS ( Mueller and Muller, 2024 ). Flavonoids, terpenoids, and anthocyanidins exhibit neuroprotective effects by modulating signaling pathways known to be impacted by COVID-19 ( Zaa et al, 2023 ). They have been shown to inhibit neuroinflammation by reducing inflammatory activation in microglia cells ( Gargouri et al, 2018 ).…”

Section: Resultsmentioning

confidence: 99%

Management of cognitive impairment associated with post-COVID-19 syndrome: recommendations for primary care

Zifko,

Guendling,

Seet

et al. 2024

Front. Pharmacol.

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Introduction: Although post-COVID-19 syndrome (PCS) with cognitive impairment is increasingly encountered in primary care, evidence-based recommendations for its appropriate management are lacking.Methods: A systematic literature search evaluating the diagnosis and treatment of cognitive impairment associated with PCS was conducted. Practical recommendations for the management of PCS-associated cognitive impairment in primary care are summarized, based on an evaluation of pharmacological plausibility and clinical applications.Results: Currently, the pathology of cognitive impairment associated with PCS remains unclear with no high-quality data to support targeted interventions. Existing treatment approaches are directed towards symptom relief where counseling on the chronicity of the disease and regular reassessments at 4- to 8-week intervals is considered reasonable. Patients should be informed and encouraged to adopt a healthy lifestyle that centers around balanced nutrition and appropriate physical activities. They may also benefit from the intake of vitamins, micronutrients, and probiotics. The administration of Ginkgo biloba extract could offer a safe and potentially beneficial treatment option. Other non-pharmacological measures include physiotherapy, digitally supported cognitive training, and, if indicated, ergotherapy or speech therapy. In most patients, symptoms improve within 8 weeks. If serious, ambiguous, or when new symptoms occur, specialized diagnostic measures such as comprehensive neurocognitive testing or neuroimaging should be initiated. Very few patients would require inpatient rehabilitation.Conclusion: PCS with cognitive impairment is a debilitating condition that could affect daily functioning and reduce work productivity. Management in primary care should adopt a multidisciplinary approach, centering around physical, cognitive, and pharmacological therapies.

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Section: Resultsmentioning

confidence: 99%

Management of cognitive impairment associated with post-COVID-19 syndrome: recommendations for primary care

Zifko,

Guendling,

Seet

et al. 2024

Front. Pharmacol.

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“…However, this concept can be different for many medical herbs which usually comprise different compounds with different pharmacological profiles. Therefore, they may address different targets and further may have beneficial effects on different aspects of complex diseases (Luo et al 2019 ; Zaa et al 2023 ). However, in most cases, these medical herbs have been used as different, poorly defined extracts with very different compositions and concentrations of the active ingredients making any clear interpretation for the use in patient impossible.…”

Section: Are Herbal Multitarget Drugs a Therapeutic Option?mentioning

confidence: 99%

Multi-target drugs for the treatment of cognitive impairment and fatigue in post-COVID syndrome: focus on Ginkgo biloba and Rhodiola rosea

Mueller,

Müller

2024

J Neural Transm

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Cognitive impairment, depression and (mental) fatigue represent the most frequent neuropsychiatric symptoms of the post-COVID syndrome. Neuroinflammation, oxidative stress and mitochondrial dysfunction have been identified as common pathophysiological mechanisms underlying these symptoms. Attempts to treat post-COVID-associated cognitive impairment and fatigue with different drugs available for other diseases have not yet been successful. One probable explanation could be that these drugs work by one specific mechanism of action only and not in a broad multi-target way. Therefore, they will not address the broad pathophysiological spectrum possibly responsible for cognitive impairment, depression and fatigue in post-COVID syndrome. Notably, nearly all drugs currently under investigation for fatigue in post-COVID syndrome are rather addressing one single target instead of the several pathomechanisms underlying this condition. Contrary to this approach, herbal drugs often consist of many different ingredients with different pharmacological properties and pharmacological targets. Therefore, these drugs might be a promising approach for the treatment of the broad symptomatic presentation and the pathophysiological mechanisms of cognitive impairment and fatigue following a SARS-CoV-2 infection. Of these herbal drugs, extracts of Ginkgo biloba and Rhodiola rosea probably are the best investigated candidates. Their broad pharmacological spectrum in vitro and in vivo includes anti-oxidative, anti-inflammatory, antidepressant as well as properties reducing cognitive impairment and fatigue. In several studies, both drugs showed positive effects on physical and mental fatigue and impaired cognition. Moreover, depressive symptoms were also reduced in some studies. However, even if these results are promising, the data are still preliminary and require additional proof by further studies.

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“…The olfactory nerve, or cranial nerve I, is the only cranial nerve that does not synapse before it enters the brain parenchyma. Given this method of infection, it is not surprising that SARS-CoV-2 would present with acute neurological symptoms like anosmia, headache, encephalitis, and ischemic stroke, or chronic ones such as impaired executive functions and fatigue ( 67 ).…”

Section: Long Covidmentioning

confidence: 99%

Brain FADE syndrome: the final common pathway of chronic inflammation in neurological disease

Hanafy,

Jovin

2024

Front. Immunol.

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ImportanceWhile the understanding of inflammation in the pathogenesis of many neurological diseases is now accepted, this special commentary addresses the need to study chronic inflammation in the propagation of cognitive Fog, Asthenia, and Depression Related to Inflammation which we name Brain FADE syndrome. Patients with Brain FADE syndrome fall in the void between neurology and psychiatry because the depression, fatigue, and fog seen in these patients are not idiopathic, but instead due to organic, inflammation involved in neurological disease initiation.ObservationsA review of randomized clinical trials in stroke, multiple sclerosis, Parkinson’s disease, COVID, traumatic brain injury, and Alzheimer’s disease reveal a paucity of studies with any component of Brain FADE syndrome as a primary endpoint. Furthermore, despite the relatively well-accepted notion that inflammation is a critical driving factor in these disease pathologies, none have connected chronic inflammation to depression, fatigue, or fog despite over half of the patients suffering from them.Conclusions and relevanceBrain FADE Syndrome is important and prevalent in the neurological diseases we examined. Classical “psychiatric medications” are insufficient to address Brain FADE Syndrome and a novel approach that utilizes sequential targeting of innate and adaptive immune responses should be studied.

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Neuroprotective Agents with Therapeutic Potential for COVID-19

Cited by 3 publications

References 271 publications

Management of cognitive impairment associated with post-COVID-19 syndrome: recommendations for primary care

Management of cognitive impairment associated with post-COVID-19 syndrome: recommendations for primary care

Multi-target drugs for the treatment of cognitive impairment and fatigue in post-COVID syndrome: focus on Ginkgo biloba and Rhodiola rosea

Brain FADE syndrome: the final common pathway of chronic inflammation in neurological disease

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