Neurological sequelae of long COVID: a comprehensive review of diagnostic imaging, underlying mechanisms, and potential therapeutics, 2025,Talkington+

[SNT Gatchaman]

Neurological sequelae of long COVID: a comprehensive review of diagnostic imaging, underlying mechanisms, and potential therapeutics
Talkington, Grant McGee; Kolluru, Paresh; Gressett, Timothy E.; Ismael, Saifudeen; Meenakshi, Umar; Acquarone, Mariana; Solch-Ottaiano, Rebecca J.; White, Amanda; Ouvrier, Blake; Paré, Kristina; Parker, Nicholas; Watters, Amanda; Siddeeque, Nabeela; Sullivan, Brooke; Ganguli, Nilesh; Calero-Hernandez, Victor; Hall, Gregory; Longo, Michele; Bix, Gregory J.

One lingering effect of the COVID-19 pandemic created by SARS-CoV-2 is the emergence of Long COVID (LC), characterized by enduring neurological sequelae affecting a significant portion of survivors.

This review provides a thorough analysis of these neurological disruptions with respect to cognitive dysfunction, which broadly manifest as chronic insomnia, fatigue, mood dysregulation, and cognitive impairments with respect to cognitive dysfunction. Furthermore, we characterize how diagnostic tools such as PET, MRI, EEG, and ultrasonography provide critical insight into subtle neurological anomalies that may mechanistically explain the Long COVID disease phenotype.

In this review, we explore the mechanistic hypotheses of these neurological changes, which describe CNS invasion, neuroinflammation, blood-brain barrier disruption, and gut-brain axis dysregulation, along with the novel vascular disruption hypothesis that highlights endothelial dysfunction and hypoperfusion as a core underlying mechanism. We lastly evaluate the clinical treatment landscape, scrutinizing the efficacy of various therapeutic strategies ranging from antivirals to antiinflammatory agents in mitigating the multifaceted symptoms of LC.

Link | PDF (Frontiers in Neurology) [Open Access]

 

[Eleanor]

I've tried to see if there's anything useful in here but it looks like a collection of just about everything anyone has suggested *might* be true about LC, with a lot of confident statements about microclots, faecal transplants and mouse models, etc.

 

[Eleanor]

Some rather baffling bits:

The striking similarities between Long COVID and ME/CFS symptoms, with only four symptoms previously considered unique to ME/CFS—motor disturbances, tinnitus/double vision, lymph node pain, and sensitivity to chemicals, foods, medications, or odors—now being reported among Long COVID patients in the results from the NINDS RECOVER study

The few distinct features of Long COVID—such as specific olfactory and gustatory dysfunction and particular dermatological changes—likely reflect SARS-CoV-2′s unique tissue tropism rather than fundamentally different mechanisms of illness.

and

the convergence of evidence detailing significant overlap of long COVID's neurological sequelae with those of vascular dementia