This pragmatic guide to clinical care outlines current best practices in diagnosis and treatment.

Authors: Jennifer A. Frontera, Alla Guekht, Ricardo F. Allegri ,Mariam Ashraf, Betül Baykan, Lucía Crivelli, Ava Easton, David Garcia-Azorin, Raimund Helbok, Jatin Joshi, Julia Koehn, Igor Koralnik, M. Netravathi, Benedict Michael, Annacarmen Nilo, Aynur Özge, Karanbir Padda, Gaia Pellitteri, Kameshwar Prasad, Marina Romozzi, Deanna Saylor, Adam Seed, Kiran Thakur, Derya Uluduz, Alberto Vogrig, Tamara M. Welte, Erica Westenberg, Dmitry Zhuravlev, Mikhail Zinchuk, Andrea S. Winkler

Editor's Choice
Journal of the Neurological Sciences.  REVIEW ARTICLE|  VOLUME 454, 120827, NOVEMBER 15, 2023



  • Neurological PASC symptoms are common and require a multi-disciplinary approach to treatment.
  • Evidence-based algorithms are presented for the evaluation and management of these symptoms.
  • This pragmatic guide to clinical care outlines current best practices in diagnosis and treatment.

Post-acute neurological sequelae of COVID-19 affect millions of people worldwide, yet little data is available to guide treatment strategies for the most common symptoms.

We conducted a scoping review of PubMed/Medline from 1/1/2020–4/1/2023 to identify studies addressing diagnosis and treatment of the most common post-acute neurological sequelae of COVID-19 including: cognitive impairment, sleep disorders, headache, dizziness/lightheadedness, fatigue, weakness, numbness/pain, anxiety, depression and post-traumatic stress disorder. Utilizing the available literature and international disease-specific society guidelines, we constructed symptom-based differential diagnoses, evaluation and management paradigms.

This pragmatic, evidence-based consensus document may serve as a guide for a holistic approach to post-COVID neurological care and will complement future clinical trials by outlining best practices in the evaluation and treatment of post-acute neurological signs/symptoms.