Treatment in post-COVID syndrome – nicergoline as the therapeutic potential in reduction symptoms of COVID brain fog Review article

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Konrad Rejdak
Aleksandra Karbowniczek
Monika Białecka
Wojciech Kozubski
Alina Kułakowska
Adam Wichniak
Paweł Zajdel

Abstract

The SARS-CoV-2 virus, causing the COVID-19 (coronavirus disease 2019), bring about pandemic that made unprecedently repercussions on global health, social and economic. Over 200 million people fell ill worldwide, including about 3 million in Poland [1]. Clinical observations indicate that many patients after an acute period of the COVID-19 still report chronic symptoms/symptoms resulting from dysfunction of various organs and systems [2, 3] despite the virus RNA is no longer detected. The persistence of symptoms/symptoms 4 weeks after the onset of SARS-CoV-2 infection is called the post-COVID syndrome. The available reports on the health consequences of COVID-19 shows that the post-COVID syndrome is quite common. Majority of the observations indicate that the more severe course of SARS-CoV-2 infection (defined e.g., as the need for hospitalization in the intensive care unit or the need for passive and/or active ventilation) predisposes to post-COVID syndrome, including: increased risk of symptoms  from nervous system [4–6]. These symptoms, including the neuro-COVID syndrome, may occur during acute, subacute or chronic COVID-19 phase [7]. Both, the central and peripheral nervous systems, can be affected. In the first case, it is mostly manifested by vascular incidents, brain inflammatory diseases and cognitive disorders (so-called: ‘covid brain fog’); in the second: mostly smell and taste disorders as well as various forms of neuropathy and myopathy. SARS-CoV-2 infection may also lead to the exacerbation of chronic neurological diseases and also have an impact on current treatment. All these complications need to be treated. The pandemic took the world by surprise, so new ways of treating complications are still being sought and practiced on an ongoing basis. In the neurological complications – especially in order to prevent cerebrovascular incidents and improve cognitive functioning in the course of covid brain fog – the use of nicergoline seems to be appropriate and effective.

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How to Cite
Rejdak , K., Karbowniczek, A., Białecka, M., Kozubski , W., Kułakowska , A., Wichniak, A., & Zajdel, P. (2021). Treatment in post-COVID syndrome – nicergoline as the therapeutic potential in reduction symptoms of COVID brain fog. Medycyna Faktow (J EBM), 14(3(52), 294-302. https://doi.org/10.24292/01.MF.0321.12
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References

1. https://coronavirus.jhu.edu/map.html (access: 30.09.2021).
2. Carfì A, Bernabei R, Landi F; Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020; 324(6): 603-5. http://doi.org/10.1001/jama.2020.12603.
3. Tenforde MW, Kim SS, Lindsell CJ et al; IVY Network Investigators; CDC COVID-19 Response Team; IVY Network Investigators. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network – United States, March-June 2020. MMWR Morb Mortal Wkly Rep. 2020; 69(30): 993-8. http://doi.org/10.15585/mmwr.mm6930e1.
4. Arnold DT, Hamilton FW, Milne A et al. Patient outcomes after hospitalisation with COVID-19 and implications for follow-up: results from a prospective UK cohort. Thorax. 2021; 76(4): 399-401. http://doi.org/10.1136/thoraxjnl-2020-216086.
5. Huang C, Huang L, Wang Y et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021; 397(10270): 220-32. http://doi.org/10.1016/S0140-6736(20)32656-8.
6. Halpin SJ, McIvor C, Whyatt G et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol. 2021; 93(2): 1013-22. http://doi.org/10.1002/jmv.26368.
7. Pezzini A, Padovani A. Lifting the mask on neurological manifestations of COVID-19. Nat Rev Neurol. 2020; 16(11): 636-44.
8. Chathappady House NN, Palissery S, Sebastian H. Corona Viruses: A Review on SARS, MERS and COVID-19. Microbiol Insights. 2021; 14:11786361211002481.
9. Enright PL, Sherrill DL. Reference equations for the six-minute walk in healthy adults. Am J Respir Crit Care Med. 1998; 158(5 Pt 1): 1384-7. http://doi.org/10.1164/ajrccm.158.5.9710086. Erratum in: Am J Respir Crit Care Med. 2020; 201(3): 393.
10. Taquet M, Geddes JR, Husain M et al. 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. Lancet Psychiatry. 2021; 8(5): 416-27. http://doi.org/10.1016/S2215-0366(21)00084-5.
11. Nalbandian A, Sehgal K, Gupta A et al. Post-acute COVID-19 syndrome. Nat Med. 2021; 27(4): 601-15. http://doi.org/10.1038/s41591-021-01283-z.
12. Chopra V, Flanders SA, O’Malley M et al. Sixty-Day Outcomes Among Patients Hospitalized With COVID-19. Ann Intern Med. 2021; 174(4): 576-8. http://doi.org/10.7326/M20-5661.
13. Carvalho-Schneider C, Laurent E, Lemaignen A et al. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin Microbiol Infect. 2021; 27(2): 258-63. http://doi.org/10.1016/j.cmi.2020.09.052.
14. Moreno-Pérez O, Merino E, Leon-Ramirez JM et al; COVID19-ALC research group. Post-acute COVID-19 syndrome. Incidence and risk factors: A Mediterranean cohort study. J Infect. 2021; 82(3): 378-83. http://doi.org/10.1016/j.jinf.2021.01.004.
15. Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med. 2001; 33(5): 337-43. http://doi.org/10.3109/07853890109002087.
16. Czarnowska A, Brola W, Zajkowska O et al. Clinical course and outcome of SARS-CoV-2 infection in multiple sclerosis patients treated with disease- modifying therapies – the Polish experience. Neurol Neurochir Pol. 2021; 55(2): 212-22. http://doi.org/10.5603/PJNNS.a2021.0031.
17. Helms J, Kremer S, Merdji H et al. Neurologic features in severe SARS-CoV-2 infection. N Engl J Med. 2020; 382(23): 2268-2270.
18. Yin R, Feng W, Wang T et al. Concomitant neurological symptoms observed in a patient diagnosed with coronavirus disease 2019. J Med Virol. 2020 [Epub ahead of print]. http://doi.org/10.1002/jmv.25888.
19. Zhao H, Shen D, Zhou H et al. Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol. 2020; 19: 383.
20. Gutiérrez-Ortiz C, Méndez A, Rodrigo-Rey S et al. Miller Fisher Syndrome polyneuritis cranialis in COVID-19. Neurology. 2020 [Epub ahead of print]. http://doi.org/10.1212/WNL.0000000000009619.
21. Raveendran AV, Jayadevan R, Sashidharan S. Long COVID: An overview. Diabetes Metab Syndr. 2021; 15(3): 869-75.
22. Ghannam M, Alshaer Q, Al-Chalabi M et al. Neurological involvement of coronavirus disease 2019: a systematic review. J Neurol. 2020; 267(11): 3135-53. http://doi.org/10.1007/s00415-020-09990-2.
23. Mendelson M, Nel J, Blumberg L et al. Long-COVID: An evolving problem with an extensive impact. S Afr Med J. 2020; 111(1): 10-2. http://doi.org/10.7196/SAMJ.2020.v111i11.15433.
24. Zubair AS, McAlpine LS, Gardin T et al. Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019: A Review. JAMA Neurol. 2020; 77(8): 1018-27.
25. Kanne JP, Bai H, Bernheim A et al. COVID-19 Imaging: What We Know Now and What Remains Unknown. Radiology. 2021; 204522. http://doi.org/10.1148/radiol.2021204522.
26. Afshar-Oromieh A, Prosch H, Schaefer-Prokop C et al. A comprehensive review of imaging findings in COVID-19 – status in early 2021. Eur J Nucl Med Mol Imaging. 2021; 48(8): 2500-24. http://doi.org/10.1007/s00259-021-05375-3.
27. Lee MH, Perl DP, Nair G et al. Microvascular Injury in the Brains of Patients with Covid-19. N Engl J Med. 2021; 384(5): 481-3. http://doi.org/10.1056/NEJMc2033369.
28. Gulick DH, Mandel S, Maitz EA et al. Special Report: Cognitive Screening After COVID-19. Tools are needed for the assessment of neurologic and neuropsychologic sequelae of infection with the SARS-CoV-2 virus. Pract Neurol. 2021.
29. Cheng A, Shih E, Herman E et al; OHSU Long COVID-19 Clinical Guidelines Team. Clinical Guidelines: Long COVID-19. (access: 30.09.2021).
30. Nalleballe K, Reddy Onteddu S, Sharma R et al. Spectrum of neuropsychiatric manifestations in COVID-19. Brain Behav Immun. 2020; 88: 71-4. http://doi.org/10.1016/j.bbi.2020.06.020.
31. Taquet M, Geddes JR, Husain M et al. 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. Lancet Psychiatry. 2021; 8(5): 416-27.
32. Wichniak A, Kania A, Siemiński M et al. Melatonin as a Potential Adjuvant Treatment for COVID-19 beyond Sleep Disorders. Int J Mol Sci. 2021; 22(16): 8623.
33. Marsh EB, Kornberg M, Kessler K et al; Quality Committee of the American Academy of Neurology. COVID-19 and Vaccination in the Setting of Neurologic Disease: An Emerging Issue in Neurology. Neurology. 2021. http://doi.org/10.1212/WNL.0000000000012578.
34. Zhang ZL, Zhong H, Liu YX et. Current therapeutic options for coronavirus disease 2019 (COVID-19)-lessons learned from severe acute respiratory syndrome (SARS) and Middle East Respiratory Syndrome (MERS) therapy: a systematic review protocol. Ann Transl Med. 2020; 8(22): 1527.
35. Rejdak K, Grieb P. Fluvoxamine and amantadine: central nervous system acting drugs repositioned for COVID-19 as early intervention. Curr Neuropharmacol. 2021. http://doi.org/10.2174/1570159X19666210729123734.
36. Winblad B, Fioravan M, Dolezal T et al. Therapeutic use of nicergoline. Clin Drug Inves. 2008; 28: 533-52.
37. Zajdel P, Bednarski M, Sapa J et al. Ergotamine and nicergoline – facts and myths. Pharmacol Rep. 2015; 67(2): 360-3. http://doi.org/10.1016/j.pharep.2014.10.010.
38. Fioravanti M, Nakashima T, Xu J et al. A systematic review and meta-analysis assessing adverse event profile and tolerability of nicergoline. BMJ Open. 2014; 4: e005090. http://doi.org/10.1136/bmjopen-2014-005090.
39. Nishio T, Sunohara N, Furukawa S et al. Repeated injections of nicergoline increase the nerve growth factor level in the aged rat brain. JPN J Pharmacol. 1998; 76(3): 321-3.

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