Pregledni rad
NEUROLOGICAL MANIFESTATIONS OF POST-COVID-19 SYNDROME
VANJA BAŠIĆ KES
; Klinika za neurologiju Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska; Stomatološki fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska
NEVENA GRBIĆ
; Klinika za neurologiju Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska
VIŠNJA SUPANC
; Klinika za neurologiju Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska
IRIS ZAVOREO
; Klinika za neurologiju Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska; Kineziološki fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska
LUCIJA ZADRO MATOVINA
; Klinika za neurologiju Klinički bolnički centar Sestre milosrdnice, Zagreb, Hrvatska; Stomatološki fakultet Sveučilišta u Zagrebu, Zagreb, Hrvatska
Sažetak
Introduction: At the end of 2019, a new disease named COVID-19 was discovered. The disease is caused by the new coronavirus SARS-CoV-2. A global pandemic was soon declared by the World Health Organization (WHO). The disease mostly presents by respiratory simptoms. It can also be presented by neurological symptoms and neurological complications may occur during and after treatment of COVID-19. Regardless of COVID-19 symptoms, some patients complain of persistent symptoms. In such cases, we talk of so-called post-COVID-19 syndrome. Various terms have been used in the literature for the spectrum of symptoms that occur weeks or months after COVID-19 symptoms, such as "long-COVID", "post-COVID syndrome", "consequences of SARS-CoV-2 infection". Symptoms include various manifestations of organ systems that occur and/or last longer than 4 weeks. Aim: Our aim was to analyze scientifi c papers on the topic of post-COVID-19 syndrome. We also wanted to describe the proposed pathophysiological mechanisms of post-COVID-19 syndrome and highlight the possible diagnostic algorithm. Methods: We searched the MEDLINE database using the following key features:„postCOVID-19“, „neurological manifestations“ and „long-COVID-19“ back to the year 2020. Results: Accoding to our fi ndings, there are several stages of COVID-19. Acute COVID-19 includes acute disease that lasts for 4 weeks. Ongoing symptomatic COVID-19 includes symptoms that last for 4 to 12 weeks. Post-COVID-19 syndrome involves signs and symptoms that occur during or after COVID-19 infection, last for more than 12 weeks, and cannot be explained by another diagnosis. Symptoms can affect different organ systems and may overlap and fl uctuate in intensity. The term „long COVID-19“ describes ongoing symptomatic COVID-19 and post-COVID-19 syndrome. Neurological manifestations of post-COVID-19 syndrome include weakness and fatigue, myalgia, mood disorders, and sleep disturbances. Persistent headaches, impaired concentration ("brain fog"), paresthesias, dysgeusia, hyposmia and disorders of the autonomic nervous system have also been reported in the literature. There are several proposed routes for SARS-CoV-2 to reach the central nervosu system: olfactory, hematogenous and gastointestinal. The central nervous system can be damaged directly and indirectly. "Brain fog" and memory diffi culties are explained by central and respiratory hypoxia (especially), as well as proinfl ammatory body response. In case of post-COVID-19 neurolgical symptoms, there always have to be a diagnostic approach that considers and searches for alternative diagnosis in the patient context. Basic laboratory workup with possible later extension has to be done. Also, proper neuroimaging methods, mostly brain and/or spine magnetic resonance imaging, should be performed. In some cases, a multidisciplinary approach may be required. Conclusion: We have made a review of neurological postCOVID-19 symptoms and their pathophysiological mechanism with the initial care proposed. We would also like to note that there still are numerous data on the topic that will certainly be revealed with time.
Ključne riječi
post-COVID-19; neurological manifestations; symptoms; pathophysiology; diagnosis; treatment
Hrčak ID:
280218
URI
Datum izdavanja:
7.7.2022.
Posjeta: 4.326 *