sharon sanders
Editor-in-Chief & President
J Neurol
. 2025 May 6;272(6):380. doi: 10.1007/s00415-025-13110-3
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
Dániel Bereczki [SUP]1,[/SUP][SUP]2,[/SUP][SUP]✉,[/SUP][SUP]#[/SUP], Ádám Dénes [SUP]3,[/SUP][SUP]#[/SUP], Filippo M Boneschi [SUP]4,[/SUP][SUP]5[/SUP], Tamar Akhvlediani [SUP]6[/SUP], Francesco Cavallieri [SUP]7[/SUP], Alessandra Fanciulli [SUP]8[/SUP], Saša R Filipović [SUP]9[/SUP], Alla Guekht [SUP]10,[/SUP][SUP]11[/SUP], Raimund Helbok [SUP]12,[/SUP][SUP]13[/SUP], Sonja Hochmeister [SUP]14[/SUP], Tim J von Oertzen [SUP]15[/SUP], Serefnur Özturk [SUP]16[/SUP], Alberto Priori [SUP]17,[/SUP][SUP]18[/SUP], Martin Rakusa [SUP]19[/SUP], Barbara Willekens [SUP]20,[/SUP][SUP]21[/SUP], Elena Moro [SUP]22,[/SUP][SUP]#[/SUP], Johann Sellner [SUP]23,[/SUP][SUP]#[/SUP]; on behalf of the NeuroCOVID-19 Task Force of the European Academy of Neurology
PMCID: PMC12055923 PMID: 40327103
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 inflammation, 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.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12055923/
. 2025 May 6;272(6):380. doi: 10.1007/s00415-025-13110-3
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
Dániel Bereczki [SUP]1,[/SUP][SUP]2,[/SUP][SUP]✉,[/SUP][SUP]#[/SUP], Ádám Dénes [SUP]3,[/SUP][SUP]#[/SUP], Filippo M Boneschi [SUP]4,[/SUP][SUP]5[/SUP], Tamar Akhvlediani [SUP]6[/SUP], Francesco Cavallieri [SUP]7[/SUP], Alessandra Fanciulli [SUP]8[/SUP], Saša R Filipović [SUP]9[/SUP], Alla Guekht [SUP]10,[/SUP][SUP]11[/SUP], Raimund Helbok [SUP]12,[/SUP][SUP]13[/SUP], Sonja Hochmeister [SUP]14[/SUP], Tim J von Oertzen [SUP]15[/SUP], Serefnur Özturk [SUP]16[/SUP], Alberto Priori [SUP]17,[/SUP][SUP]18[/SUP], Martin Rakusa [SUP]19[/SUP], Barbara Willekens [SUP]20,[/SUP][SUP]21[/SUP], Elena Moro [SUP]22,[/SUP][SUP]#[/SUP], Johann Sellner [SUP]23,[/SUP][SUP]#[/SUP]; on behalf of the NeuroCOVID-19 Task Force of the European Academy of Neurology
PMCID: PMC12055923 PMID: 40327103
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 inflammation, 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.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12055923/