Prevalence, pathogenesis and spectrum of neurological symptoms in COVID‐19 and post‐COVID‐19 syndrome

Josef Finsterer and Fulvio A Scorza
Med J Aust 2024; 220 (6): . || doi: 10.5694/mja2.52235
Published online: 1 April 2024

To the Editor: Wesselingh's narrative review1 is excellent but, in our view, omitted some potentially important points. The spectrum of central and peripheral nervous system complications of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infections is probably broader than stated in the review. In addition to the complications listed in the article (eg, headache, peripheral neuropathy, seizures, encephalitis, Guillain–Barré syndrome, movement disorders and cerebrovascular disease), the neurological symptoms of coronavirus disease 2019 (COVID‐19) may also include complications such as acute disseminated encephalomyelitis, acute haemorrhagic necrotising encephalitis, acute haemorrhagic leucoencephalitis, acute necrotising encephalopathy, multiple sclerosis, myelin oligodendrocyte glycoprotein‐associated disease, pituitary apoplexy, opsoclonus–myoclonus syndrome, cerebellitis, myelitis, myasthenia, myasthenic syndrome, myositis, myopathy and rhabdomyolysis.2 However, it is important to note that all of these potential complications are derived from observational studies that lacked a control group for comparison.

  • 1 Neurology and Neurophysiology Center, Vienna, Austria
  • 2 Federal University of São Paulo, São Paulo, Brazil


Competing interests:

No relevant disclosures.

  • 1. Wesselingh R. Prevalence, pathogenesis and spectrum of neurological symptoms in COVID‐19 and post‐COVID‐19 syndrome: a narrative review. Med J Aust 2023; 219: 230‐236.‐pathogenesis‐and‐spectrum‐neurological‐symptoms‐covid‐19‐and‐post
  • 2. Finsterer J. Ischemic stroke in a SARS‐CoV‐2‐positive octagenarian without cardiovascular risk factors: a case report. Cureus 2022; 14: e23654.
  • 3. Finsterer J, Scorza FA. Clinical and pathophysiologic spectrum of neuro‐COVID. Mol Neurobiol 2021; 58: 3787‐3791.
  • 4. Giannis D, Goldin M, Rahman H, et al. Risk factors for postdischarge major thromboembolism and mortality in hospitalized patients with COVID‐19 with cardiovascular comorbidities: insights from the CORE‐19 Registry. Thromb Haemost 2023; 123: 1089‐1099.
  • 5. Peng K, Li X, Yang D, et al. Risk of autoimmune diseases following COVID‐19 and the potential protective effect from vaccination: a population‐based cohort study. EClinicalMedicine 2023; 63: 102154.


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