CLINICAL ASPECTS OF NEUROLOGICAL MANIFESTATIONS OF LONG COVID AND PROSPECTS FOR PHYSIOTHERAPEUTIC INTERVENTIONS (REVIEW OF LITERATURE)

Abstract

Post-acute sequelae of SARS-CoV-2 is a multisystem classification. Its sole defining criterion is the persistence of neurological or neuropsychiatric symptoms beyond the 12-week post-infection mark. Clinical presentation is heterogeneous but dominated by two core symptoms: profound asthenia and significant cognitive dysfunction (memory/attention deficits). A secondary cluster of high-prevalence symptoms is recognized: cephalalgia, dizziness, dyssomnia, sensorimotor deficits, and persistent olfactory/gustatory dysfunction. Psychiatric involvement is common, with documented high rates of anxiety, depression, and PTSD.

International meta-analyses demonstrate the high prevalence of these symptoms within the first 6–12 months, with a tendency to persist for several years. Data from Ukrainian cohorts indicate even higher rates of fatigue, sleep disorders, and anosmia compared to European populations.

The low efficacy of pharmacotherapy necessitates the investigation of non-drug interventions, particularly physiotherapeutic modalities. While modalities like Pulsed Electromagnetic Field therapy and Transcranial Magnetic Stimulation show initial promise against asthenia, cognitive deficits, and psychoemotional symptoms, their utility is unproven. The current evidence base is fundamentally unusable. It is derived exclusively from underpowered pilot data and case series. Validation, therefore, is entirely dependent on future large-scale Randomized Clinical Trials. These trials require mandatory components: rigid, standardized protocols and a reliance on objective, quantifiable endpoints. Efficacy (or lack thereof) must be demonstrated using neuropsychological tests, biomarker quantification, and functional neuroimaging, not subjective reports.