Post-COVID-19-Syndrom: Ein heterogenes Krankheitsbild aus der Sicht der Neurologie

Post COVID-19 condition has recently been defined by the World Health Organization as symptoms that occur in individuals with a history of probable or confirmed severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection, usually 3 months from the onset of COVID-19 with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. Besides fatigue and persistent pulmonary symptoms, neurological and neuropsychiatric manifestations have also been described. Pathophysiological mechanisms remain unclear, although current hypotheses discuss virus-associated pathologies, changes in neurotransmitter and persistent inflammation. Diagnostic workup for patients with neurological symptoms include neurological clinical examination, neuroimaging, laboratory analysis and neuropsychiatric diagnostics depending on the objectivity of neurological findings. Currently, a symptom-oriented management principle is recommended because up to now, no evidence for a specific treatment from randomized controlled clinical trials exists. In most patients, symptoms resolve over time. In severe cases with complex multiorgan features, a multimodal interdisciplinary management plan is recommended.