This review examines the long-term neurological effects of SARS-CoV-2 infection, focusing on its impact on the brain and memory. It explores the molecular mechanisms by which SARS-CoV-2 invades the brain, including direct infection via olfactory nerves, hematogenous spread, and infection via the optic nerve. The review details the role of ACE2 and other host factors in supporting viral replication and discusses the detrimental effects of SARS-CoV-2-mediated syncytia formation. The impact on memory storage regions of the brain is analyzed, along with the potential mechanisms involving direct viral infection, immune dysfunction, and persistent infection. Risk factors for long COVID, including cytokine storms, autoantibodies, and microclots, are considered, alongside strategies for reducing the incidence of long COVID, such as vaccination, antiviral treatments, and lifestyle modifications.

Qiulu Ding, Hanjun Zhao