Post Covid Syndrome and Cognitive Dysfunction – Aetiology and Possible Treatment

Background: Cognitive dysfunction is not infrequent after recovery from SARS-Cov-2 infection and often accompanied by fatigue and several of the other symptoms seen in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Post-Covid Syndrome (PCS) inflammation impairs mental function through a combination of altered attention and cognition. Here we discuss the relationship between infection, peripheral and central inflammation, and cerebral and cognitive dysfunction in patients with PCS. Methods: Review of the relevant literature and personal clinical research work. Results: Cognitive dysfunction in PCS is multifactorial and has several similarities to that in ME/CFS. It likely arises from low grade persistent inflammation associated with sleep dysfunction and altered mood with endothelial dysfunction leading to altered regional cerebral blood flow and accompanied by disturbed neuronal function. Immune dysregulation initiated by reactivation of previously acquired herpes type viruses and leading to reduced mitochondrial energy generation and subtle autoimmunity targeting one or more neuronal and autonomic receptors may also be contributing factors. Treatments used in ME/CFS, and aimed at these factors, used collectively may provide benefit. Conclusion: Reducing low grade systemic inflammation, viral reactivation and immune dysregulation has the potential to improve cognitive dysfunction in PCS.