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 and Dénes, Ádám and Boneschi, Filippo M. and Akhvlediani, Tamar and Cavallieri, Francesco and Fanciulli, Alessandra and Filipović, Saša R. and Guekht, Alla and Helbok, Raimund and Hochmeister, Sonja and von Oertzen, Tim J. and Özturk, Serefnur and Priori, Alberto and Rakusa, Martin and Willekens, Barbara and Moro, Elena and Sellner, Johann (2025) 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. JOURNAL OF NEUROLOGY, 272 (6). No. 380. ISSN 0340-5354

Preview

Text Needforawarenessandsurveillanceoflong-termpost-COVIDneurodegenerativedisorders.ApositionpaperfromtheneuroCOVID19taskforceoftheEuropeanAcademyofNeurology.pdf - Published Version Available under License Creative Commons Attribution. Download (835kB) | Preview

Abstract

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 infammation, 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.

Actions (login required)

Edit Item