Michael Geschwind, MD, PhD, FAAN, Memory and Aging Center, University of California, San Francisco, CA, sheds light on the complex nature of long COVID. This syndrome, still lacking a consensus definition, refers to diverse symptoms, neurological and otherwise, lasting at least 2 months after initial COVID onset, often extending much longer. It occurs not just in severe COVID cases but also in mild infections. Common symptoms include brain fog, gastrointestinal upset, musculoskeletal pain, and debilitating fatigue. Researchers are exploring four main avenues for its cause: autoimmune activation, direct viral injury, latent virus, and viral reactivation from other dormant viruses. At CONy 2024, Dr Geschwind presented evidence that suggests there is an autoimmune component to long COVID. For example, studies have described the generation of cross-reactive antibodies in the acute-COVID stages. Nervous system inflammation has also been seen in long COVID patients, suggesting a potential autoimmune link. This interview took place at the 18th Annual Congress on Controversies in Neurology (CONy 2024) in London, UK.
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