E0 ConsensusPreliminaryPEM ?Review-NarrativePeer-reviewedMachine draft
The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 infection.
Moghimi, Narges, Di Napoli, Mario, Biller, José et al. · Current neurology and neuroscience reports · 2021 · DOI
Quick Summary
This review examined what we know about how COVID-19 can affect the nervous system in people who experience long-term symptoms after infection (called PASC or long COVID). The researchers looked at published studies to understand how common these neurological problems are, who is most at risk, why they happen, and how they might be treated. They found that long COVID can range from mild to severely disabling symptoms that last weeks or longer, and that multiple factors—including lingering inflammation, immune system problems, and possible viral effects on the brain—may play a role.
Why It Matters
Understanding the neurological mechanisms of post-viral sequelae like PASC is critical for ME/CFS research, as both conditions share overlapping symptoms and unclear pathophysiology. This review consolidates evidence about potential mechanisms—immune dysregulation, chronic inflammation, and possible viral persistence—that may apply to ME/CFS patients as well. Early identification and multidisciplinary treatment approaches outlined here could inform clinical management strategies for patients with post-viral conditions.
Observed Findings
- PASC is described as a multi-organ disorder with severity ranging from mild to incapacitating, lasting weeks or longer post-infection.
- Multiple pathophysiological mechanisms are proposed, including direct or indirect viral brain invasion, immune dysregulation, cytokine-mediated chronic inflammation, hormonal disturbances, and persistent low-grade infection.
- Neurological manifestations occur in a substantial proportion of COVID-19 survivors.
- Early identification of affected individuals is needed for appropriate treatment.
- Multidisciplinary treatment approaches are necessary, combining pharmacological, rehabilitation, and cognitive therapy interventions.
Inferred Conclusions
- PASC represents a complex, multi-mechanism disorder requiring a systems-based approach to diagnosis and management.
- A combination of tailored rehabilitation, novel cognitive therapy protocols, and pharmacological treatments is needed for effective neuro-PASC management.
- Increased awareness among healthcare professionals and the public is essential for early detection and treatment of neuro-PASC.
- Further research is urgently needed to clarify pathophysiological mechanisms and optimize treatment strategies for this emerging condition.
Remaining Questions
What This Study Does Not Prove
This review does not prove that any single mechanism causes neuro-PASC; it summarizes multiple proposed theories without establishing which are primary. The paper does not demonstrate that PASC and ME/CFS are identical conditions, though they share features. It also cannot establish causation from the published studies reviewed—most demonstrate associations rather than definitive causal pathways.
Tags
Symptom:Cognitive DysfunctionFatigue
Biomarker:CytokinesNeuroimaging
Phenotype:Infection-TriggeredLong COVID Overlap
Method Flag:PEM Not DefinedExploratory Only
Metadata
- DOI
- 10.1007/s11910-021-01130-1
- PMID
- 34181102
- Review status
- Machine draft
- Evidence level
- Established evidence from major reviews, guidelines, or evidence maps
- Last updated
- 8 April 2026