Carod-Artal, F J, García-Moncó, J C · Neurology perspectives · 2021 · DOI
This review examines long-term symptoms people experience after COVID-19 infection, particularly neurological (brain and nerve-related) symptoms like brain fog, memory problems, headaches, and sleep issues. The authors found that post-COVID-19 syndrome is complex and variable—affecting different people in different ways—and likely involves multiple causes including immune system changes, nerve dysfunction, and possibly persistent viral effects. Because the definition and criteria for post-COVID-19 syndrome remain unclear, reported rates of occurrence vary dramatically, ranging from 2% to 85% depending on the study.
This review is relevant to ME/CFS patients and researchers because post-COVID-19 syndrome and ME/CFS share overlapping neurological symptoms (fatigue, cognitive impairment, sleep disruption) and may share pathophysiological mechanisms. Understanding post-COVID-19 pathophysiology may illuminate ME/CFS etiology and inform therapeutic approaches for both conditions. The identification of multiple potential disease mechanisms supports the need for personalized, multidisciplinary treatment strategies.
This narrative review does not establish causation or definitively prove which proposed mechanisms (immune dysfunction, viral persistence, neural changes) are primary versus secondary in post-COVID-19 syndrome. The study does not provide a validated diagnostic criterion or case definition for post-COVID-19, nor does it clarify how to reliably distinguish post-COVID-19 from ME/CFS or critical illness syndrome. The wide prevalence range (2.3%–85%) reflects definitional ambiguity rather than true epidemiological precision.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Carod-Artal, F J & García-Moncó, J C (2021). Epidemiology, pathophysiology, and classification of the neurological symptoms of post-COVID-19 syndrome.. Neurology perspectives. https://doi.org/10.1016/j.neurop.2021.07.005
BibTeX
@article{mecfsatlas-carod-artal-2021-epidemiology-pathophysiology,
author = {Carod-Artal, F J and García-Moncó, J C},
title = {Epidemiology, pathophysiology, and classification of the neurological symptoms of post-COVID-19 syndrome.},
journal = {Neurology perspectives},
year = {2021},
doi = {10.1016/j.neurop.2021.07.005},
note = {PubMed: 36798683},
url = {https://www.mecfsatlas.com/evidence/carod-artal-2021-epidemiology-pathophysiology},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/carod-artal-2021-epidemiology-pathophysiology
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