Chronic post-Covid syndrome with neuro-cognitive symptoms in a patient with multiple comorbidities

Case presentation

Abstract

Chronic forms of Covid-19 represent a distinct pathology, in relation to the acute form of the disease, with a polymorphic symptomatology that persists for weeks or even months. Recent literature describes several types of post-Covid-19 syndromes, some with detectable lesion substrate, in several organs, and others without organ damage detectable by the usual methods of investigation.

The present study aims to explore this form of disease which is often extremely debilitating affecting the quality of life of patients and their ability to work and in some cases being followed by permanent sequelae that require the application of special rehabilitation programs.

The present case describes a patient with multiple comorbidities who, after an acute episode of Covid-19, developed a symptomatology dominated by intense physical and mental fatigue, vertigo, cognitive disorders and sleep disorders. To these were added respiratory and cardiac symptoms.

The evolution was progressive in the first months, which determined the patient to request specialized consultations. On this occasion, the patient underwent laboratory tests, imaging examinations (native and contrast-enhanced brain MRI) and video-EEG. The results of these investigations led to the discovery of a de novo atheroma plaque in the cerebral arteries and a desaturation of oxygen during sleep that suggests the presence of a sleep apnea syndrome.

As a result of these findings, a number of therapeutic indications have been formulated as well as recommendations for the adoption of a recovery program in order to increase the patient's quality of life, restore work capacity and reduce chronic fatigue.

The case study concludes with a series of recommendations for clinical research that the authors consider necessary in order to increase the level of understanding of these chronic forms of post-Covid-19 pathology.