Neurological and systemic manifestations in Long covid: Underestimated sequel of covid’s pandora!

Abstract

COVID-19 pandemic is phase of decline worldwide and in short time declared as pandemic is over. Globally, more than half cases are now facing either one vague or nonspecific and or organic symptoms in post covid phase. Long covid symptoms has significant impact on quality of life in those cases suffered from disease in recent past and lingering to almost two years since infection. Importantly, not all cases of COVID-19 were shown long covid symptoms. Most common long covid symptoms as joint pain, fatigability, chest discomfort, shortness of breath, hair loss, chest pain, weight gain, anxiety/depression & memory impairment. Neurological, gastrointestinal, renal, endocrine & rheumatological systems were badly affected in long covid. Brain fog, renal dysfunction, and diabetes mellitus were frequently documented as systemic manifestations of long covid. Pathophysiology resulting into long covid manifestations is still not completely validated. Researchers have reported ‘immune dysregulation’, ‘autoimmunity’, ‘antigenic mimicry’ & ‘coagulation abnormalities’ are probable pathophysiological mechanism for long covid. Some of the long covid effects shown complete reversibility including post covid lung fibrosis. Reboot system to restore immune dysregulation and recovery in long covid is real concern. Protocolised approach is required for timely workup of cases with long covid symptoms. Effect of vaccination in preventing long covid is not known and impact of evolution of new strains COVID-19 in future on ongoing long covid is real concern.