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Advanced Neurology SARS-CoV-2 mechanisms of neurological impact

Table 2. Summary of key findings on the persistence of neurological disorders and the emergence of new conditions following
COVID‑19 infection
Phase/time Neurological conditions Observations Key findings References
post‑infection
Acute phase Headaches, cognitive • Increased risk compared to COVID-19 has been associated with a wide 68,69
(0 – 30 days) dysfunction, movement controls range of neurological conditions, with headaches
disorders, cerebrovascular • Hospitalized patients at higher and cognitive dysfunction being the most
disease, neuropathies, risk commonly reported. Less frequent conditions
seizures include movement disorders and seizures
Post-acute phase Neurocognitive dysfunction, • Higher risk compared to Persistence of neurological symptoms like 56,76
(1 – 3 months) encephalopathy, stroke, SARS-CoV-2-negative controls cognitive dysfunction and fatigue; elevated
movement disorders, • Associated with higher risks for encephalopathy, stroke, and seizures;
neuropathy, anxiety, fatigue, morbidity and mortality the consistency of these manifestations
seizures, headache remains mixed
Post-acute phase Encephalopathy, dementia, • Prolonged neurological sequelae Continued neurological symptoms, with 73-75
(3 – 9 months) seizures, brain fog, myelitis, • Ongoing risk of cognitive increasing incidences of encephalopathy,
inflammatory myopathy, dysfunction, brain fog, and seizures, and dementia; a higher risk for
coma seizures inflammatory myopathy and coma; the
prolonged impact of brain fog and dementia
remains a significant concern
Long-term Cognitive deficits, • Varying results depending on Longer-term complications, particularly cognitive 17,56,81
(9 months onwards) encephalopathy, dementia, the observational period dysfunction and encephalopathy, persist.
myopathies, stroke, • Inconsistent findings on stroke However, studies on stroke and parkinsonism
parkinsonism (inconsistent and parkinsonism have shown inconsistent results, suggesting the
findings) need for standardized research methodologies
Stroke risk Stroke risk, especially in • Mixed findings across studies Conflicting data regarding stroke risk 56,86
(post-infection, 1 individuals with peripheral • Varying observational periods post-COVID-19: some studies reported
month – 1 year) inflammatory diseases yielded different results an elevated stroke risk in the early months
following infection, while others showed no
increased risk. Standardized methodologies
are required to clarify these discrepancies
PASC (>3 months) Neurocognitive deficits, • High incidence of persistent Neurological manifestations of PASC are diverse, 64,65
autonomic dysfunction, neurological symptoms including cognitive deficits, mood disturbances,
mood disorders, anosmia • Need for further investigation and autonomic dysfunction. While studies
indicate increased risk of these symptoms,
replication of findings remains inconsistent
Abbreviations: COVID‑19: Coronavirus disease 2019; PASC: Post‑acute sequelae of SARS‑CoV‑2 infection; SARS‑CoV‑2: Severe acute respiratory
syndrome coronavirus 2.

including increased incidences of encephalopathy, sequelae assessed, observation timelines, control
dementia, seizures, brain fog, and myelitis within 1 week group selection, variable adjustments, and outcome
– 3 months post-infection. In the 3 – 9-month post- measurements – complicate comparisons across studies.
acute phase, higher rates of inflammatory myopathy, Future research should aim to standardize methodologies
coma, and continued increases in brain fog, seizures, and and outcome measures to facilitate more reliable
dementia have been observed. These findings underscore comparisons and enhance understanding of the range and
the prolonged risk of neurological diseases following impact of neurological sequelae associated with PASC.
COVID-19 infection, highlighting the need for ongoing Establishing consistent protocols and comprehensive
medical follow-up (Table 2). 73-76 assessment criteria will improve the ability to draw
Similarly, other large cohort studies have documented meaningful conclusions and inform effective interventions.
increased incidences of post-COVID-19 encephalopathy, Several studies, including both clinical and basic
cognitive deficits, dementia, and myopathies. However, research, have revealed that patients with peripheral
findings related to stroke and epilepsy/seizures have been inflammatory and immune-related diseases may have
inconsistent, with no clear evidence linking COVID-19 an increased risk of stroke, highlighting the importance
to Parkinsonism. 6,14,17,56,70-72,77-81 Variations in study of monitoring these individuals. 82,83 However, two large
methodologies – including differences in the neurological studies assessing stroke risk from 1 month – 1 year post-

Volume 4 Issue 2 (2025) 16 doi: 10.36922/an.4909