Stefanou, Maria-Ioanna, Panagiotopoulos, Evangelos, Palaiodimou, Lina et al. · EXCLI journal · 2024 · DOI
This review examines the nerve and brain-related symptoms that can persist after COVID-19 infection, which doctors call long COVID. About one-third of COVID-19 survivors experience lasting neurological problems such as fatigue, brain fog, sleep issues, and problems with smell or taste that can last at least 12 months. The authors discuss what we currently know about why these symptoms happen and what treatments might help.
This comprehensive review is highly relevant to ME/CFS because long COVID and ME/CFS share numerous overlapping symptoms and potentially similar pathophysiological mechanisms (neuroinflammation, metabolic dysfunction, post-exertional malaise). Understanding long COVID's neurological manifestations may illuminate shared disease pathways and inform more effective diagnostic and therapeutic strategies that benefit both patient populations. The emphasis on multimodal, rehabilitation-based approaches aligns with evidence-based ME/CFS management principles.
As a narrative review rather than a primary research study, this does not provide new empirical data or definitive proof of causation for long COVID's neurological symptoms. The review acknowledges that pathophysiological mechanisms remain incompletely elucidated and that existing therapeutic evidence is preliminary with significant methodological limitations. The substantial phenotypic overlap with ME/CFS does not establish whether these are related conditions or distinct diseases.
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 →
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Primary citation
Stefanou, Maria-Ioanna, Panagiotopoulos, Evangelos, Palaiodimou, Lina, Bakola, Eleni, Smyrnis, Nikolaos, Papadopoulou, Marianna, et al. (2024). Current update on the neurological manifestations of long COVID: more questions than answers.. EXCLI journal. https://doi.org/10.17179/excli2024-7885
BibTeX
@article{mecfsatlas-stefanou-2024-current-update,
author = {Stefanou, Maria-Ioanna and Panagiotopoulos, Evangelos and Palaiodimou, Lina and Bakola, Eleni and Smyrnis, Nikolaos and Papadopoulou, Marianna and Moschovos, Christos and Paraskevas, George P and Rizos, Emmanouil and Boutati, Eleni and Tzavellas, Elias and Gatzonis, Stylianos and Mengel, Annerose and Giannopoulos, Sotirios and Tsiodras, Sotirios and Kimiskidis, Vasilios K and Tsivgoulis, Georgios},
title = {Current update on the neurological manifestations of long COVID: more questions than answers.},
journal = {EXCLI journal},
year = {2024},
doi = {10.17179/excli2024-7885},
note = {PubMed: 39850323},
url = {https://www.mecfsatlas.com/evidence/stefanou-2024-current-update},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-28. https://www.mecfsatlas.com/evidence/stefanou-2024-current-update
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