Need for awareness and surveillance of long-term post-COVID neurodegenerative disorders. A position paper…, 2025, Bereczki+

[SNT Gatchaman]

Need for awareness and surveillance of long-term post-COVID neurodegenerative disorders. A position paper from the neuroCOVID‐19 task force of the European Academy of Neurology
Bereczki, Dániel; Dénes, Ádám; Boneschi, Filippo M.; Akhvlediani, Tamar; Cavallieri, Francesco; Fanciulli, Alessandra; Filipović, Saša R.; Guekht, Alla; Helbok, Raimund; Hochmeister, Sonja; von Oertzen, Tim J.; Özturk, Serefnur; Priori, Alberto; Rakusa, Martin; Willekens, Barbara; Moro, Elena; Sellner, Johann

BACKGROUND
Neuropathological and clinical studies suggest that infection with SARS-CoV-2 may increase the long-term risk of neurodegeneration.

METHODS
We provide a narrative overview of pathological and clinical observations justifying the implementation of a surveillance program to monitor changes in the incidence of neurodegenerative disorders in the years after COVID-19.

RESULTS
Autopsy studies revealed diverse changes in the brain, including loss of vascular integrity, microthromboses, gliosis, demyelination, and neuronal-and glial injury and cell death, in both unvaccinated and vaccinated individuals irrespective of the severity of COVID-19. Recent data suggest that microglia play an important role in sustained COVID-19-related inflammation, which contributes to the etiology initiating a neurodegenerative cascade, to the worsening of pre-existing neurodegenerative disease or to the acceleration of neurodegenerative processes. Histopathological data have been supported by neuroimaging, and epidemiological studies also suggested a higher risk for neurodegenerative diseases after COVID-19.

CONCLUSIONS
Due to the high prevalence of COVID-19 during the pandemic, healthcare systems should be aware of, and be prepared for a potential increase in the incidence of neurodegenerative diseases in the upcoming years. Strategies may include follow-up of well-described cohorts, analyses of outcomes in COVID-19-registries, nationwide surveillance programs using record-linkage of ICD-10 diagnoses, and comparing the incidence of neurodegenerative disorders in the post-pandemic periods to values of the pre-pandemic years. Awareness and active surveillance are particularly needed, because diverse clinical manifestations due to earlier SARS-CoV-2 infections may no longer be quoted as post-COVID-19 symptoms, and hence, increasing incidence of neurodegenerative pathologies at the community level may remain unnoticed.

Link | PDF (Journal of Neurology) [Open Access]

 

[SNT Gatchaman]

Neurological manifestations after COVID-19 may be multifaceted and long-lasting. The associations of the neuropathological changes in the acute phase with subsequent neurodegeneration are highly likely and the role of inflammation as an underlying mechanism is emerging. An increase in the incidence of neurodegenerative diseases might be expected. Awareness is particularly needed given that clinical manifestations months or years after SARS-CoV-2 infections may no longer be quoted as post-COVID symptoms, and hence, progressing pathologies at the community level may remain unnoticed.

Probably should have been considered before letting it rip and forcing multiple infections on… the entire world.

 

[Wyva]

I see the first two authors contributed equally to this paper, one of whom is Ádám Dénes. I've mentioned him several times here on the forum as he is one of the Hungarian long covid researchers most prominently featured in the media here. Unfortunately he never mentions ME/CFS or even just PEM. He even says exercise and cognitive rehabilitation can be beneficial for long covid. I understand that ME/CFS is not a neurodegenerative disease (which is the focus of this paper) but I find it odd that he never acknowledges its existence in any way at all, ever, anywhere.