Post Covid-19 Neurological Syndrome

1. Ade Wijaya, MD – September 2021

2.  Coronavirus disease-19 (COVID-19) is the
disease caused by Severe Acute Respiratory
Syndrome Corona Virus-2 (SARS-CoV-2) and is
firstly a respiratory disease.
 The pathobiology of COVID-19 begins with the
virus targeting the angiotensin enzyme two
(ACE-2) receptors which are ubiquitous
throughout the body, including neural tissues 
neurological symptoms
 Post COVID-19  1/3 develop neurological
symptoms
S. Najjar, A. Najjar, D.J. Chong, B.K. Pramanik, C. Kirsch, R.I. Kuzniecky, et al., Central nervous system complications associated with SARS-CoV-2 infection: integrative concepts of
pathophysiology and case reports, J. Neuroinflammation 17 (1) (2020) 231.
South K, McCulloch L, McColl BW, Elkind MS, Allan SM, Smith CJ. Preceding infection and risk of stroke: an old concept revived by the COVID-19 pandemic. Int. J.
Stroke.0(0):(1747493020943815)
Wijeratne T, Crewther S. Post-COVID 19 Neurological Syndrome (PCNS); a novel syndrome with challenges for the global neurology community. Journal of the neurological sciences.
2020 Dec 15;419.
Rudroff, T.; Fietsam, A.C.; Deters, J.R.; Bryant, A.D.; Kamholz, J. Post-COVID-19 Fatigue: Potential Contributing Factors. Brain Sci. 2020, 10, 1012

3.  Anosmia
 Ageusia or dysgeusia
 Headache
 Muscle and joint pain
 Fatigue and mental fog
Can last weeks to monts
Rudroff, T.; Fietsam, A.C.; Deters, J.R.; Bryant, A.D.; Kamholz, J. Post-COVID-19 Fatigue: Potential Contributing Factors. Brain Sci. 2020, 10, 1012

4.  Delirium and psychosis
 Inflammatory syndromes (such as
encephalitis and acute disseminated
encephalomyelitis)
 Ischemic and hemorrhagic strokes
 Neuro- and myopathies
Nuzzo D, Cambula G, Bacile I, Rizzo M, Galia M, Mangiapane P, Picone P, Giacomazza D, Scalisi L. Long-term brain disorders in post Covid-19 neurological syndrome (PCNS) patient.
Brain Sciences. 2021 Apr;11(4):454.

5. Balaini, Neeraj & Modi, Manish. (2020). COVID-19 and Neurological Manifestations. Annals of the National Academy of Medical Sciences (India). 56. 10.1055/s-0040-1714153.

6. S. Najjar, A. Najjar, D.J. Chong, B.K. Pramanik, C. Kirsch, R.I. Kuzniecky, et al., Central nervous system complications associated with SARS-CoV-2 infection: integrative concepts of
pathophysiology and case reports, J. Neuroinflammation 17 (1) (2020) 231.

7.  We need to be aware of post COVID-19
syndrome including neurological.
 More studies needed to determine the
optimal management.