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Molecular Mechanisms of Cognitive Dysfunction from COVID-19 Infection and Other Respiratory Viruses

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: 20 November 2025 | Viewed by 1018

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Guest Editor
Faculty of Music, University of Toronto, Toronto, ON M5S 2C5, Canada
Interests: neuromodulation; vibration; vibroacoustic; chronic pain; respiratory disease; physical therapy

Special Issue Information

Dear colleagues,

On May 5th, 2023, the WHO officially ended the Public Health Emergency of International Concern (PHEIC) for the COVID-19 pandemic. Although the pandemic is considered to be “over,” there are many who continue to feel the lasting effects of COVID-19. Post-COVID-19 syndrome, or "long COVID," has emerged as a real concern for the young and old, and the infection and reinfection rates for COVID variants keep this threat looming large. Most notable of post-COVID symptoms are those related to fatigue and cognitive dysfunction. The result of these symptoms on quality of life ranges from reduced productivity to complete dependency. Therefore, it has become important to understand the link between viral infections and cognitive dysfunction, and work towards solutions.

The explosion of research stimulated by the pandemic has led to rapid advances in our knowledge of the molecular mechanisms of COVID-19, from the cytokine storm to disruption of the blood-brain barrier in patients exhibiting post-COVID symptoms. Interestingly, these cognitive symptoms are also present after infection from other respiratory viruses, suggesting that there may be a common underlying mechanism. Synthesizing our knowledge of this mechanism and investigating the shared mechanisms of COVID, we may be able to answer questions about post-COVID symptoms before obtaining years of longitudinal follow-up data. For example, evidence from shared mechanisms of other respiratory infections may help us determine the likelihood of post-COVID symptoms being permanent, reversible, or reoccurring by nature.

In this Special Issue, entitled “Molecular mechanisms of cognitive dysfunction from COVID-19 infection and other respiratory viruses”, we aim to present research and theoretical papers addressing all these points relating to respiratory viral infections. I believe that this Special Issue of the International Journal of Molecular Sciences will be greatly beneficial to serve our continuing understanding of this disease.

Dr. Abdullah Mosabbir
Guest Editor

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Keywords

  • long COVID
  • post-COVID
  • cognitive dysfunction
  • virus
  • cognition
  • brain
  • viral infection
  • virol-ogy
  • RNA

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Published Papers (1 paper)

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Review

25 pages, 1595 KiB  
Review
The Molecular Mechanisms of Cognitive Dysfunction in Long COVID: A Narrative Review
by Elena Popa, Andrei Emilian Popa, Mihaela Poroch, Vladimir Poroch, Monica Iuliana Ungureanu, Ana Maria Slanina, Agnes Bacusca and Elena Adorata Coman
Int. J. Mol. Sci. 2025, 26(11), 5102; https://doi.org/10.3390/ijms26115102 - 26 May 2025
Viewed by 818
Abstract
Cognitive dysfunction represents one of the most persistent and disabling features of Long COVID, yet its molecular underpinnings remain incompletely understood. This narrative review synthesizes current evidence on the pathophysiological mechanisms linking SARS-CoV-2 infection to long-term neurocognitive sequelae. Key processes include persistent neuroinflammation, [...] Read more.
Cognitive dysfunction represents one of the most persistent and disabling features of Long COVID, yet its molecular underpinnings remain incompletely understood. This narrative review synthesizes current evidence on the pathophysiological mechanisms linking SARS-CoV-2 infection to long-term neurocognitive sequelae. Key processes include persistent neuroinflammation, blood–brain barrier (BBB) disruption, endothelial dysfunction, immune dysregulation, and neuroendocrine imbalance. Microglial activation and cytokine release (e.g., IL-6, TNF-α) promote synaptic dysfunction and neuronal injury, while activation of inflammasomes such as NLRP3 amplifies CNS inflammation. Vascular abnormalities, including microthrombosis and BBB leakage, facilitate the infiltration of peripheral immune cells and neurotoxic mediators. Hypothalamic–pituitary–adrenal axis dysfunction and reduced vagal tone further exacerbate systemic inflammation and autonomic imbalance. Biomarkers such as GFAP, NFL, IL-6, and S100B have been associated with both neuroinflammation and cognitive symptoms. Notably, transcriptomic signatures in Long COVID overlap with those observed in Alzheimer’s disease, highlighting shared pathways involving tau dysregulation, oxidative stress, and glial reactivity. Understanding these mechanisms is critical for identifying at-risk individuals and developing targeted therapeutic strategies. This review underscores the need for longitudinal research and integrative biomarker analysis to elucidate the molecular trajectory of cognitive impairment in Long COVID. Full article
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