Long-Term Neurologic Sequelae of COVID-19: Emerging Insights Into Post-Acute Neuropsychiatric and Cognitive Syndromes

Introduction: COVID-19, initially understood as a respiratory illness, has emerged as a multisystemic disease with persistent post-acute sequelae. Of growing concern is the impact of SARS-CoV-2 on the nervous system, particularly long after the acute infection has resolved.Objective: This review synthesizes emerging evidence regarding long-term neurologic sequelae of COVID-19, with emphasis on cognitive, psychiatric, and structural brain changes, and highlights novel mechanisms and future research directions.Methods: A literature review was conducted across PubMed, Scopus, and Google Scholar databases for peer-reviewed articles between 2020–2024. We focused on observational studies, imaging-based research, and reviews related to long COVID and its neurologic manifestations.Results: Long COVID is associated with brain fog, fatigue, memory deficits, and depression/anxiety persisting for months post-infection. Neuroimaging studies have revealed structural changes in the frontal cortex and limbic system, while pathophysiologic hypotheses include viral neuroinvasion, neuroinflammation, microvascular injury, and persistent immune dysregulation.Conclusion: COVID-19's neurologic footprint persists beyond the acute phase, resembling neurodegenerative and mood disorders. Understanding these effects is critical for developing targeted therapies and rehabilitation strategies. This review underscores the urgency of integrative research into post-viral neuropsychiatric conditions.