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DOI: 10.1055/a-1927-4006
Neurologische Langzeitfolgen von COVID-19
Die COVID-19-Pandemie hat den öffentlichen Gesundheitssektor vor ungeahnte Herausforderungen gestellt. Doch während die gesellschaftliche Belastung durch die akute Erkrankung abzunehmen scheint, ebben die Berichte über Langzeitfolgen nicht ab. Mitunter am häufigsten berichtet werden neurologische Beschwerden wie anhaltende Erschöpfung und Kognitionsstörungen. Der wissenschaftliche Kenntnisstand entwickelt sich rasant und erste Therapieansätze zeichnen sich ab. Doch noch immer sind viele Fragen offen.
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Neurologische Langzeitfolgen nach COVID-19 sind häufig. Die am häufigsten berichteten Beschwerden sind Fatigue und Kognitionsstörungen.
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Die WHO definiert das Post-COVID-19-Syndrom als über 12 Wochen anhaltende Beschwerden nach der Akutinfektion ohne eine andere erklärende Erkrankung.
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Die Pathophysiologie des Post-COVID-19-Syndroms ist nicht abschließend geklärt. Eine Vielzahl an Ursachen wird diskutiert, darunter postinfektiöse Endorganschäden, Koagulopathien und Endothelschäden sowie autoimmunvermittelte Schäden.
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Die Diagnostik sollte leitsymptomorientiert und unter Zuhilfenahme der jeweiligen Leitlinien erfolgen.
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Es existieren noch keine für das Post-COVID-19-Syndrom zugelassenen Therapieverfahren. Allerdings werden zahlreiche Therapien bereits in Studien geprüft, und es ist von einem raschen Kenntniszuwachs auszugehen.
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Die Therapie erfolgt derzeit in erster Linie symptomatisch.
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Interdisziplinäre Behandlungsansätze unter Einbezug somatischer und psychischer Fachrichtungen stellen ein zentrales Konzept in der Behandlung dar.
Publication History
Article published online:
05 March 2024
© 2024. Thieme. All rights reserved.
Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany
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Literatur
- 1 Johns Hopkins University - Coronavirus Resource Center. COVID-19 Dashboard. 2023. Accessed December 20, 2023 at: https://coronavirus.jhu.edu/map.html
- 2 Ritschel N, Radbruch H, Herden C. et al. COVID-19: Auswirkungen auf das zentrale und periphere Nervensystem. Pathologe 2021; 42: 172-182 DOI: 10.1007/s00292-021-00924-x.
- 3 Misra S, Kolappa K, Prasad M. et al. Frequency of neurologic manifestations in COVID-19: a systematic review and meta-analysis. Neurology 2021; 97: e2269-e2281 DOI: 10.1212/WNL.0000000000012930. (PMID: 34635561)
- 4 Alberti P, Beretta S, Piatti M. et al. Guillain-Barré syndrome related to COVID-19 infection. Neurol-Neuroimmunol 2020; 7: e741 DOI: 10.1212/nxi.0000000000000741. (PMID: 32350026)
- 5 Arnaud S, Budowski C, Ng Wing Tin S. et al. Post SARS-CoV-2 Guillain-Barre syndrome. Clin Neurophysiol 2020; 131: 1652-1654 DOI: 10.1016/j.clinph.2020.05.003.
- 6 Gutiérrez-Ortiz C, Méndez-Guerrero A, Rodrigo-Rey S. et al. Miller Fisher syndrome and polyneuritis cranialis in COVID-19. Neurology 2020; 95: e601-e605 DOI: 10.1212/wnl.0000000000009619. (PMID: 32303650)
- 7 Toscano G, Palmerini F, Ravaglia S. et al. Guillain–Barré syndrome associated with SARS-CoV-2. N Engl J Med 2020; 382: 2574-2576 DOI: 10.1056/nejmc2009191.
- 8 Chaumont H, Etienne P, Roze E. et al. Acute meningoencephalitis in a patient with COVID-19. Rev Neurol 2020; 176: 519-521 DOI: 10.1016/j.neurol.2020.04.014.
- 9 Duong L, Xu P, Liu A. Meningoencephalitis without respiratory failure in a young female patient with COVID-19 infection in Downtown Los Angeles, early April 2020. Brain Behav Immun 2020; 87: 33 DOI: 10.1016/j.bbi.2020.04.024.
- 10 Moriguchi T, Harii N, Goto J. et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis 2020; 94: 55-58 DOI: 10.1016/j.ijid.2020.03.062.
- 11 Pilotto A, Odolini S, Masciocchi S. et al. Steroid-responsive encephalitis in coronavirus disease 2019. Ann Neurol 2020; 88: 423-427 DOI: 10.1002/ana.25783. (PMID: 32418288)
- 12 Watson OJ, Barnsley G, Toor J. et al. Global impact of the first year of COVID-19 vaccination: a mathematical modelling study. Lancet Infect Dis 2022; 22: 1293-1302 DOI: 10.1016/s1473-3099(22)00320-6. (PMID: 35753318)
- 13 Soriano JB, Murthy S, Marshall JC. et al. A clinical case definition of post-COVID-19 condition by a Delphi consensus. Lancet Infect Dis 2022; 22: e102-e107 DOI: 10.1016/s1473-3099(21)00703-9. (PMID: 34951953)
- 14 European Centre for Disease Prevention and Control. Prevalence of post COVID-19 condition symptoms: a systematic review and meta-analysis of cohort study data, stratified by recruitment setting. Stockholm: European Centre for Disease Prevention and Control. 2022
- 15 World Health Organization (WHO). Post COVID-19 condition (Long COVID). 2022 Accessed December 22, 2023 at: https://www.who.int/europe/news-room/fact-sheets/item/post-covid-19-condition
- 16 AOK Bundesverband. Post-Covid-Erkrankungen: Wenige Betroffene aber lange Ausfallzeiten. 2023 Accessed December 22, 2023 at: https://www.aok.de/pp/bv/pm/post-covid-erkrankungen/
- 17 Techniker Krankenkasse. Zwei Jahre Corona-Pandemie: Wie geht es Deutschlands Beschäftigten?. 2022 Accessed December 20, 2023 at: https://www.tk.de/resource/blob/2130932/70a0d93d19f6444f06310379441bd046/gesundheitsreport-2022-data.pdf
- 18 Tsampasian V, Elghazaly H, Chattopadhyay R. et al. Risk factors associated with post−COVID-19 condition. JAMA Int Med 2023; 183: 566 DOI: 10.1001/jamainternmed.2023.0750.
- 19 Herman JD, Atyeo C, Zur Y. et al. Humoral immunity to an endemic coronavirus is associated with postacute sequelae of COVID-19 in individuals with rheumatic diseases. Sci Transl Med 2023; 15: eadf6598 DOI: 10.1126/scitranslmed.adf6598.
- 20 Lundberg-Morris L, Leach S, Xu Y. et al. Covid-19 vaccine effectiveness against post-covid-19 condition among 589 722 individuals in Sweden: population based cohort study. BMJ 2023; 383: e076990 DOI: 10.1136/bmj-2023-076990.
- 21 Joy G, Artico J, Kurdi H. et al. Prospective case-control study of cardiovascular abnormalities 6 months following mild COVID-19 in healthcare workers. JACC Cardiovasc Imaging 2021; 14: 2155-2166 DOI: 10.1016/j.jcmg.2021.04.011. (PMID: 33975819)
- 22 Matheson AM, McIntosh MJ, Kooner HK. et al. Longitudinal follow-up of postacute COVID-19 syndrome: DLCOquality-of-life and MRI pulmonary gas-exchange abnormalities. Thorax 2023; 78: 418-421 DOI: 10.1136/thorax-2022-219378.
- 23 Murata N, Yamada A, Fujito H. et al. Cardiovascular manifestations identified by multi-modality imaging in patients with long COVID. Front Cardiovasc Med 2022; 9: 968584 DOI: 10.3389/fcvm.2022.968584.
- 24 Remy-Jardin M, Duthoit L, Perez T. et al. Assessment of pulmonary arterial circulation 3 months after hospitalization for SARS-CoV-2 pneumonia: dual-energy CT (DECT) angiographic study in 55 patients. EClinicalMedicine 2021; 34: 100778 DOI: 10.1016/j.eclinm.2021.100778. (PMID: 33817609)
- 25 Altmann DM, Whettlock EM, Liu S. et al. The immunology of long COVID. Nat Rev Immunol 2023; 23: 618-634 DOI: 10.1038/s41577-023-00904-7. (PMID: 37433988)
- 26 Douaud G, Lee S, Alfaro-Almagro F. et al. SARS-CoV-2 is associated with changes in brain structure in UK Biobank. Nature 2022; 604: 697-707 DOI: 10.1038/s41586-022-04569-5.
- 27 Frosolini A, Parrino D, Fabbris C. et al. Magnetic resonance imaging confirmed olfactory bulb reduction in long COVID-19: Literature review and case series. Brain Sci 2022; 12: 430 DOI: 10.3390/brainsci12040430. (PMID: 35447962)
- 28 Blazhenets G, Schroeter N, Bormann T. et al. Slow but evident recovery from neocortical dysfunction and cognitive impairment in a series of chronic COVID-19 patients. J Nucl Med 2021; 62: 910-915 DOI: 10.2967/jnumed.121.262128.
- 29 Díez-Cirarda M, Yus M, Gómez-Ruiz N. et al. Multimodal neuroimaging in post-COVID syndrome and correlation with cognition. Brain 2023; 146: 2142-2152 DOI: 10.1093/brain/awac384.
- 30 Etter MM, Martins TA, Kulsvehagen L. et al. Severe Neuro-COVID is associated with peripheral immune signatures, autoimmunity and neurodegeneration: a prospective cross-sectional study. Nat Commun 2022; 13: 6777 DOI: 10.1038/s41467-022-34068-0.
- 31 Conway EM, Mackman N, Warren RQ. et al. Understanding COVID-19-associated coagulopathy. Nat Rev Immun 2022; 22: 639-649 DOI: 10.1038/s41577-022-00762-9. (PMID: 35931818)
- 32 Lee M-H, Perl DP, Nair G. et al. Microvascular injury in the brains of patients with Covid-19. N Engl J Med 2020; 384: 481-483 DOI: 10.1056/NEJMc2033369.
- 33 Emmenegger M, Kumar SS, Emmenegger V. et al. Anti-prothrombin autoantibodies enriched after infection with SARS-CoV-2 and influenced by strength of antibody response against SARS-CoV-2 proteins. PLOS Pathogens 2021; 17: e1010118 DOI: 10.1371/journal.ppat.1010118.
- 34 Kell DB, Laubscher GJ, Pretorius E. A central role for amyloid fibrin microclots in long COVID/PASC: origins and therapeutic implications. Biochem J 2022; 479: 537-559 DOI: 10.1042/BCJ20220016. (PMID: 35195253)
- 35 Pretorius E, Venter C, Laubscher GJ. et al. Prevalence of symptoms, comorbidities, fibrin amyloid microclots and platelet pathology in individuals with Long COVID/Post-Acute Sequelae of COVID-19 (PASC). Cardiovasc Diabetol 2022; 21: 148 DOI: 10.1186/s12933-022-01579-5.
- 36 Cheung CCL, Goh D, Lim X. et al. Residual SARS-CoV-2 viral antigens detected in GI and hepatic tissues from five recovered patients with COVID-19. Gut 2022; 71: 226-229 DOI: 10.1136/gutjnl-2021-324280.
- 37 Swank Z, Senussi Y, Manickas-Hill Z. et al. Persistent circulating severe acute respiratory syndrome coronavirus 2 spike is associated with post-acute coronavirus disease 2019 sequelae. Clin Infect Dis 2023; 76: e487-e490 DOI: 10.1093/cid/ciac722.
- 38 Stein SR, Ramelli SC, Grazioli A. et al. SARS-CoV-2 infection and persistence in the human body and brain at autopsy. Nature 2022; 612: 758-763 DOI: 10.1038/s41586-022-05542-y. (PMID: 36517603)
- 39 Gold JE, Okyay RA, Licht WE. et al. Investigation of long COVID prevalence and its relationship to Epstein-Barr virus reactivation. Pathogens 2021; 10: 763 DOI: 10.3390/pathogens10060763. (PMID: 34204243)
- 40 Su Y, Yuan D, Chen DG. et al. Multiple early factors anticipate post-acute COVID-19 sequelae. Cell 2022; 185: 881-895e820 DOI: 10.1016/j.cell.2022.01.014.
- 41 Zubchenko S, Kril I, Nadizhko O. et al. Herpesvirus infections and post-COVID-19 manifestations: a pilot observational study. Rheumatol Int 2022; 42: 1523-1530 DOI: 10.1007/s00296-022-05146-9. (PMID: 35650445)
- 42 Franke C, Ferse C, Kreye J. et al. High frequency of cerebrospinal fluid autoantibodies in COVID-19 patients with neurological symptoms. Brain Behav Immun 2021; 93: 415-419 DOI: 10.1016/j.bbi.2020.12.022.
- 43 Richter AG, Shields AM, Karim A. et al. Establishing the prevalence of common tissue-specific autoantibodies following severe acute respiratory syndrome coronavirus 2 infection. Clin Exp Immunol 2021; 205: 99-105 DOI: 10.1111/cei.13623. (PMID: 34082475)
- 44 Son K, Jamil R, Chowdhury A. et al. Circulating anti-nuclear autoantibodies in COVID-19 survivors predict long-COVID symptoms. Eur Respir J 2023; 61: 2200970 DOI: 10.1183/13993003.00970-2022.
- 45 Song E, Bartley CM, Chow RD. et al. Divergent and self-reactive immune responses in the CNS of COVID-19 patients with neurological symptoms. Cell Rep Med 2021; 2: 100288 DOI: 10.1016/j.xcrm.2021.100288.
- 46 Wallukat G, Hohberger B, Wenzel K. et al. Functional autoantibodies against G-protein coupled receptors in patients with persistent Long-COVID-19 symptoms. J Transl Autoimmun 2021; 4: 100100 DOI: 10.1016/j.jtauto.2021.100100.
- 47 Zuo Y, Estes SK, Ali RA. et al. Prothrombotic autoantibodies in serum from patients hospitalized with COVID-19. Sci Transl Med 2020; 12: eabd3876 DOI: 10.1126/scitranslmed.abd3876.
- 48 Franke C, Boesl F, Goereci Y. et al. Association of cerebrospinal fluid brain-binding autoantibodies with cognitive impairment in post-COVID-19 syndrome. Brain Behav Immun 2023; 109: 139-143 DOI: 10.1016/j.bbi.2023.01.006.
- 49 Monje M, Iwasaki A. The neurobiology of long COVID. Neuron 2022; 110: 3484-3496 DOI: 10.1016/j.neuron.2022.10.006. (PMID: 36288726)
- 50 Alkodaymi MS, Omrani OA, Fawzy NA. et al. Prevalence of post-acute COVID-19 syndrome symptoms at different follow-up periods: a systematic review and meta-analysis. Clin Microbiol Infect 2022; 28: 657-666 DOI: 10.1016/j.cmi.2022.01.014. (PMID: 35124265)
- 51 Lopez-Leon S, Wegman-Ostrosky T, Perelman C. et al. More than 50 long-term effects of COVID-19: a systematic review and meta-analysis. Sci Rep 2021; 11: 16144 DOI: 10.1038/s41598-021-95565-8.
- 52 Subramanian A, Nirantharakumar K, Hughes S. et al. Symptoms and risk factors for long COVID in non-hospitalized adults. Nat Med 2022; 28: 1706-1714 DOI: 10.1038/s41591-022-01909-w. (PMID: 35879616)
- 53 Ballering AV, Van Zon SKR, Olde Hartman TC. et al. Persistence of somatic symptoms after COVID-19 in the Netherlands: an observational cohort study. Lancet 2022; 400: 452-461 DOI: 10.1016/s0140-6736(22)01214-4.
- 54 Premraj L, Kannapadi NV, Briggs J. et al. Mid and long-term neurological and neuropsychiatric manifestations of post-COVID-19 syndrome: a meta-analysis. J Neurol Sci 2022; 434: 120162 DOI: 10.1016/j.jns.2022.120162. (PMID: 35121209)
- 55 Ceban F, Ling S, Lui LMW. et al. Fatigue and cognitive impairment in Post-COVID-19 syndrome: a systematic review and meta-analysis. Brain Behav Immun 2022; 101: 93-135 DOI: 10.1016/j.bbi.2021.12.020. (PMID: 34973396)
- 56 Boesl F, Audebert H, Endres M. et al. A neurological outpatient clinic for patients with post-COVID-19 syndrome - a report on the clinical presentations of the first 100 patients. Front Neurol 2021; 12: 738405 DOI: 10.3389/fneur.2021.738405.
- 57 Schou TM, Joca S, Wegener G. et al. Psychiatric and neuropsychiatric sequelae of COVID-19 - a systematic review. Brain Behav Immun 2021; 97: 328-348 DOI: 10.1016/j.bbi.2021.07.018. (PMID: 34339806)
- 58 Franke C, Warnke C, Gorsler A. et al. Neurologische Manifestationen bei Patienten mit Post-COVID-19-Syndrom. DGNeurologie 2021; 4: 276-280 DOI: 10.1007/s42451-021-00345-3.
- 59 Berlit P, Bösel J, Franke C. et al. Neurologische Manifestationen bei COVID-19, S2k-Leitlinie. In: Deutsche Gesellschaft für Neurologie, Hrsg. Leitlinien für Diagnostik und Therapie in der Neurologie. 2022 Accessed December 22, 2023 at: https://www.dgn.org/leitlinien
- 60 Franke C, Warnke C, Gorsler A. et al. Neurologische Manifestationen bei Patienten mit Post-COVID-19-Syndrom. DGNeurologie in Anlehnung an 2021; 4: 276-280
- 61 Nasreddine ZS, Phillips NA, Bédirian V. et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53: 695-699 DOI: 10.1111/j.1532-5415.2005.53221.x. (PMID: 15817019)
- 62 Deuschl G, Maier W. S3-Leitlinie Demenzen. In: Deutsche Gesellschaft für Neurologie, Hrsg. Leitlinien für Diagnostik und Therapie in der Neurologie. 2016 Accessed December 22, 2023 at: https://www.dgn.org/leitlinien
- 63 Nacul L, Authier FJ, Scheibenbogen C. et al. European Network on Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (EUROMENE): expert consensus on the diagnosis, service provision, and care of people with ME/CFS in Europe. Medicina 2021; 57: 510 DOI: 10.3390/medicina57050510.
- 64 Krupp LB. The fatigue severity scale. Arch Neurol 1989; 46: 1121 DOI: 10.1001/archneur.1989.00520460115022. (PMID: 2803071)
- 65 Jackson C. The chalder fatigue scale (CFQ 11). Occup Med 2015; 65: 86-86 DOI: 10.1093/occmed/kqu168. (PMID: 25559796)
- 66 Guenther S, Loebel M, Mooslechner AA. et al. Frequent IgG subclass and mannose binding lectin deficiency in patients with chronic fatigue syndrome. Hum Immunol 2015; 76: 729-735 DOI: 10.1016/j.humimm.2015.09.028.
- 67 Carruthers BM, Jain AK, De Meirleir KL. et al. Myalgic encephalomyelitis/chronic fatigue syndrome. J Chronic Fatigue Syndr 2003; 11: 7-115 DOI: 10.1300/j092v11n01_02.
- 68 Khan AM, Piccirillo J, Kallogjeri D. et al. Efficacy of combined visual-olfactory training with patient-preferred scents as treatment for patients with COVID-19 resultant olfactory loss. JAMA Otolaryngol Head Neck Surg 2023; 149: 141 DOI: 10.1001/jamaoto.2022.4112.
- 69 Ghali A, Lacombe V, Ravaiau C. et al. The relevance of pacing strategies in managing symptoms of post-COVID-19 syndrome. J Transl Med 2023; 21: 375 DOI: 10.1186/s12967-023-04229-w. (PMID: 37291581)
- 70 Parker M, Sawant HB, Flannery T. et al. Effect of using a structured pacing protocol on post-exertional symptom exacerbation and health status in a longitudinal cohort with the post-COVID-19 syndrome. J Med Virol 2023; 95: e28373 DOI: 10.1002/jmv.28373.
- 71 Rosenfeld MJ. H.E.L.P. JAMA 1985; 253: 2043 DOI: 10.1001/jama.1985.03350380059009. (PMID: 3856040)
- 72 Fox T, Hunt BJ, Ariens RAS. et al. Plasmapheresis to remove amyloid fibrin(ogen) particles for treating the post-COVID-19 condition. Cochrane Database Syst Rev 2023; 7: CD015775 DOI: 10.1002/14651858.CD015775. (PMID: 37491597)
- 73 Achleitner M, Steenblock C, Dänhardt J. et al. Clinical improvement of Long-COVID is associated with reduction in autoantibodies, lipids, and inflammation following therapeutic apheresis. Mol Psychiatry 2023; 28: 2872-2877 DOI: 10.1038/s41380-023-02084-1.
- 74 Ludwig B, Olbert E, Trimmel K. et al. The overview on current evidence for the treatment of ME/CFS is based on the principles of scientific assessment. Nervenarzt 2023; 94: 738-740 DOI: 10.1007/s00115-023-01516-1. (PMID: 37368010)
- 75 Brazier JE, Harper R, Jones NM. et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ 1992; 305: 160-164 DOI: 10.1136/bmj.305.6846.160. (PMID: 1285753)
- 76 Tarlov AR. The medical outcomes study. JAMA 1989; 262: 925 DOI: 10.1001/jama.1989.03430070073033. (PMID: 2754793)
- 77 Stein E, Heindrich C, Wittke K. et al. Observational study of repeat immunoadsorption (RIA) in Post-COVID ME/CFS patients with elevated β2-adrenergic receptor autoantibodies—an interim report. J Clin Med 2023; 12: 6428 DOI: 10.3390/jcm12196428.
- 78 Gottfried I, Schottlender N, Ashery U. Hyperbaric oxygen treatment—from mechanisms to cognitive improvement. Biomolecules 2021; 11: 1520 DOI: 10.3390/biom11101520. (PMID: 34680155)
- 79 Tal S, Hadanny A, Sasson E. et al. Hyperbaric oxygen therapy can induce angiogenesis and regeneration of nerve fibers in traumatic brain injury patients. Front Hum Neurosci 2017; 11: 508 DOI: 10.3389/fnhum.2017.00508. (PMID: 29097988)
- 80 Zilberman-Itskovich S, Catalogna M, Sasson E. et al. Hyperbaric oxygen therapy improves neurocognitive functions and symptoms of post-COVID condition: randomized controlled trial. Sci Rep 2022; 12: 11252 DOI: 10.1038/s41598-022-15565-0. (PMID: 35821512)
- 81 Rus CP, de Vries BEK, de Vries IEJ. et al. Treatment of 95 post-Covid patients with SSRIs. Sci Rep 2023; 13: 18599 DOI: 10.1038/s41598-023-45072-9.
- 82 Mazza MG, Zanardi R, Palladini M. et al. Rapid response to selective serotonin reuptake inhibitors in post-COVID depression. Eur Neuropsychopharmacol 2022; 54: 1-6 DOI: 10.1016/j.euroneuro.2021.09.009. (PMID: 34634679)
- 83 Macaya RF, Schultze P, Smith FW. et al. Thrombin-binding DNA aptamer forms a unimolecular quadruplex structure in solution. Proc Natl Acad Sci 1993; 90: 3745-3749 DOI: 10.1073/pnas.90.8.3745. (PMID: 8475124)
- 84 Weisshoff H, Krylova O, Nikolenko H. et al. Aptamer BC 007 - efficient binder of spreading-crucial SARS-CoV-2 proteins. Heliyon 2020; 6: e05421 DOI: 10.1016/j.heliyon.2020.e05421. (PMID: 33163683)
- 85 Markham A, Duggan S. Vericiguat: First approval. Drugs 2021; 81: 721-726 DOI: 10.1007/s40265-021-01496-z. (PMID: 33770393)
- 86 O'Kelly B, Vidal L, McHugh T. et al. Safety and efficacy of low dose naltrexone in a long covid cohort; an interventional pre-post study. Brain Behav Immun 2022; 24: 100485 DOI: 10.1016/j.bbih.2022.100485. (PMID: 35814187)
- 87 Mateu L, Tebe C, Loste C. et al. Determinants of the onset and prognosis of the post-COVID-19 condition: a 2-year prospective observational cohort study. Lancet Reg Health Eur 2023; 33: 100724 DOI: 10.1016/j.lanepe.2023.100724. (PMID: 37954002)
- 88 Finsterer J. Neurological side effects of SARS-CoV-2 vaccinations. Acta Neurol Scand 2022; 145: 5-9 DOI: 10.1111/ane.13550. (PMID: 34750810)
- 89 Sriwastava S, Sharma K, Khalid S. et al. COVID-19 Vaccination and neurological manifestations: a review of case reports and case series. Brain Sci 2022; 12: 407 DOI: 10.3390/brainsci12030407. (PMID: 35326363)
- 90 Klugar M, Riad A, Mekhemar M. et al. Side effects of mRNA-based and viral vector-based COVID-19 vaccines among German healthcare workers. Biology 2021; 10: 752 DOI: 10.3390/biology10080752.
- 91 Scholkmann F, May C-A. COVID-19, post-acute COVID-19 syndrome (PACS, “long COVID”) and post-COVID-19 vaccination syndrome (PCVS, “post-COVIDvac-syndrome”): similarities and differences. Pathol Res Pract 2023; 246: 154497 DOI: 10.1016/j.prp.2023.154497. (PMID: 37192595)
- 92 Riad A, Pokorná A, Attia S. et al. Prevalence of COVID-19 vaccine side effects among healthcare workers in the Czech Republic. J Clin Med 2021; 10: 1428 DOI: 10.3390/jcm10071428.