COVID: the Ongoing Pandemic with the Neurological Long Manifestations

Background. The novel SARS-CoV-2 virus initiated one of humanity’s biggest pandemics, swiftly spreading worldwide and inducing significant health issues. This virus prompted widespread changes, with initial inadequate immune response and a lack of effective drug therapies. Consequently, every organ, particularly the respiratory and nervous systems, was susceptible to infection. The Covid-19 pandemic ended in 2023, but ongoing symptoms led to the term Long Covid and chronic manifestations. Objective: The aim of this article was to describe the important role of health professionals, especially family physicians and their teams when and how to identify common neurological symptoms and clinical conditions during pandemic and post-pandemic period. Methods. A systematic review gathered data on neurological symptoms and complications in Covid-19 patients, ranging from mild, like headache, to severe, such as encephalitis and stroke. Results and Discussion. Analysis revealed a significant proportion of Covid-19 patients experiencing neurological manifestations, with about one-third exhibiting symptoms. Epidemiological data showed ongoing Long Covid symptoms alongside acute manifestations. Many of cases with Long Covid related neurological complications were presented. Common neurological manifestations included chronic fatigue, changes in smell and taste, brain fog, headaches, fibromyalgia, cognitive impairment, and mood disorders. Severe Covid-19 cases were more likely to exhibit neurological complications, such as ischemic brain vasculitis and thromboembolic events, associated with higher mortality rates. Neurological complications of Covid-19 are frequent and diverse, necessitating a multidisciplinary approach in diagnosis and treatment, coordinated by primary care physicians. In practice, it is necessary to monitor the patient’s immune status over a longer period, and coagulation disorders (D-dimer) for adequate therapy and rehabilitation. Very important is to recognize the immune response after an acute infection. Due to the epidemic occurrence of Long Covid, it is necessary to introduce the above-mentioned procedures also in case of clinical signs of Long Covid. There are several hypotheses for the causes of Long COVID symptoms, including immune disorders, persistence of the virus in various organs, and microvascular coagulation changes. Within primary healthcare as the first line of defense it is necessary to address stress caused by COVID-19, try to recognize the affected other organ systems. Conclusion: The family doctor with his communication skills can make connection with the secondary and tertiary levels and the consulting services of immunologists, microbiologists, nutritionists, pharmacist, physiatrist and infectiologist. The family medicine team plays a key role in prevention, random detection and adequate medical procedures. The main interventions at the primary level should include education, emotional support, specific nutrition interventions and lifestyle modifications.