Post-COVID 19 Neurological Syndrome (PCNS) presents with a wide spectrum of disabling symptoms that include cognitive dysfunction, persistent fatigue, mood disturbance, autonomic dysregulation, and sensory abnormalities. These symptoms are often long lasting, multifactorial, and poorly addressed in current clinical practice. While no single treatment has proven universally effective, there is growing evidence to support a range of therapeutic strategies that target inflammation, neuroplasticity, psychological resilience, and functional recovery. This chapter reviews the current therapeutic options for PCNS, including pharmacological, non-pharmacological, and integrative approaches. We explore the use of neurorehabilitation, cognitive behavioural therapies, graded activity programs, autonomic rebalancing strategies, and emerging digital therapeutics. We also examine promising treatments under investigation, including immunomodulatory agents and neuromodulation techniques. Importantly, we address the current limitations in evidence, including the lack of robust data, fragmented care pathways, and inadequate training. We call for urgent, well-designed multicenter collaborative clinical trials to guide safe, effective, and scalable interventions. Special attention is given to personalizing care based on symptom clusters, functional goals, and comorbidities. By synthesizing current evidence and expert consensus, this chapter aims to provide clinicians with a practical, hopeful, and evidence informed path forward.

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Therapeutic Options for Post-COVID 19 Neurological Syndrome

  • Reuben Parama Iswara,
  • Tissa Wijeratne

摘要

Post-COVID 19 Neurological Syndrome (PCNS) presents with a wide spectrum of disabling symptoms that include cognitive dysfunction, persistent fatigue, mood disturbance, autonomic dysregulation, and sensory abnormalities. These symptoms are often long lasting, multifactorial, and poorly addressed in current clinical practice. While no single treatment has proven universally effective, there is growing evidence to support a range of therapeutic strategies that target inflammation, neuroplasticity, psychological resilience, and functional recovery. This chapter reviews the current therapeutic options for PCNS, including pharmacological, non-pharmacological, and integrative approaches. We explore the use of neurorehabilitation, cognitive behavioural therapies, graded activity programs, autonomic rebalancing strategies, and emerging digital therapeutics. We also examine promising treatments under investigation, including immunomodulatory agents and neuromodulation techniques. Importantly, we address the current limitations in evidence, including the lack of robust data, fragmented care pathways, and inadequate training. We call for urgent, well-designed multicenter collaborative clinical trials to guide safe, effective, and scalable interventions. Special attention is given to personalizing care based on symptom clusters, functional goals, and comorbidities. By synthesizing current evidence and expert consensus, this chapter aims to provide clinicians with a practical, hopeful, and evidence informed path forward.