{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:57:41Z","timestamp":1747173461616,"version":"3.40.5"},"reference-count":20,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>The devastating effects of the coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may not end when the acute illness has terminated. A subset of COVID-19 patients may have symptoms that persist for months. This condition has been described as \u2018long COVID\u2019. From a historical perspective, it has been recognized that serious long-term neurological sequelae have been associated with RNA viruses such as influenza viruses and coronaviruses. A potential intervention for early post-COVID-19 neuropsychiatric impairment may be the commonly employed, readily available, reasonably priced macrolide antibiotic, azithromycin. We have observed a favourable clinical response with azithromycin in three patients with neurological symptoms associated with long COVID-19. We recommend considering formal clinical trials using azithromycin for patients with post-COVID-19 infection neurological changes including \u2018COVID fog\u2019 or the more severe neurological symptoms that may later develop.<\/jats:p>","DOI":"10.1017\/s0950268823001966","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T01:46:51Z","timestamp":1702604811000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["Post-COVID-19 neuropsychiatric manifestations: a suggested therapeutic approach to \u2018long COVID\u2019 with azithromycin"],"prefix":"10.1017","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3036-3825","authenticated-orcid":false,"given":"Robert A.","family":"Schwartz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Suskind","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"S0950268823001966_r6","doi-asserted-by":"crossref","first-page":"227","DOI":"10.3988\/jcn.2017.13.3.227","article-title":"). 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What we have learned from the COVID-19 pandemic: time to think outside the box, maybe far outside","volume":"39","author":"Lambert","year":"2021","journal-title":"Clinics in Dermatology"},{"key":"S0950268823001966_r4","doi-asserted-by":"crossref","first-page":"n1648","DOI":"10.1136\/bmj.n1648","article-title":"Long covid-mechanisms, risk factors, and management","volume":"374","author":"Crook","year":"2021","journal-title":"British Medical Journal"},{"key":"S0950268823001966_r10","unstructured":"[10] Collins, FS (2021). NIH launches new initiative to study \u201cLong COVID\u201d. Available at https:\/\/www.nih.gov\/about-nih\/who-we-are\/nih-director\/statements\/nih-launches-new-initiative-study-long-covid (accessed 12 July 2023)."},{"key":"S0950268823001966_r1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1016\/j.clindermatol.2020.12.006","article-title":"Pandemics throughout the centuries","volume":"39","author":"Schwartz","year":"2021","journal-title":"Clinics in Dermatology"},{"key":"S0950268823001966_r8","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.bbi.2020.03.031","article-title":"Nervous system involvement after infection with COVID-19 and other coronaviruses","volume":"87","author":"Wu","year":"2020","journal-title":"Brain, Behavior, and Immunogy"},{"key":"S0950268823001966_r19","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1007\/s40261-020-00933-3","article-title":"). Azithromycin for COVID-19: more than just an antimicrobial?","volume":"40","author":"Bleyzac","year":"2020","journal-title":"Clinical Drug Investigation"},{"key":"S0950268823001966_r2","first-page":"e13544","article-title":"COVID-19 with dermatologic manifestations and implications: an unfolding conundrum","volume":"9","author":"Almutairi","year":"2020","journal-title":"Dermatologic Therapy"},{"key":"S0950268823001966_r11","doi-asserted-by":"crossref","first-page":"e13785","DOI":"10.1111\/dth.13785","article-title":"Azithromycin and COVID-19: prompt early use at first signs of this infection in adults and children, an approach worthy of consideration","volume":"33","author":"Schwartz","year":"2020","journal-title":"Dermatologic Therapy"},{"key":"S0950268823001966_r5","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.bbi.2020.04.027","article-title":"Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms","volume":"87","author":"Troyer","year":"2020","journal-title":"Brain, Behavior, and Immunogy"},{"key":"S0950268823001966_r12","unstructured":"[12] https:\/\/clinicaltrials.gov\/ct2\/results?cond=COVID-19&term=azithromycin&cntry=US&state=&city=&dist= (accessed 12 July 2023)."},{"key":"S0950268823001966_r20","doi-asserted-by":"crossref","first-page":"e28852","DOI":"10.1002\/jmv.28852","article-title":"). A systematic review and meta-analysis of long-term sequelae of COVID-19 2-year after SARS-CoV-2 infection: a call to action for neurological, physical, and psychological sciences","volume":"95","author":"Rahmati","year":"2023","journal-title":"Journal of Medical Virology"},{"key":"S0950268823001966_r16","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.hrtlng.2023.03.004","article-title":"). Clinical efficacy of Azithromycin for COVID-19 management: a systematic meta-analysis of meta-analyses","volume":"60","author":"Yousafzai","year":"2023","journal-title":"Heart and Lung"},{"key":"S0950268823001966_r18","first-page":"CD015025","article-title":"Antibiotics for the treatment of COVID-19","volume":"10","author":"Popp","year":"2021","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"S0950268823001966_r9","unstructured":"[9] Keller, E (2022). Neuro-COVID-19: Neurological Complications of COVID-19 (Neuro-COVID). Available at https:\/\/clinicaltrials.gov\/ct2\/show\/NCT04418609 (accessed 12 July 2023)."},{"key":"S0950268823001966_r13","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1002\/wmh3.472","article-title":"Public health issues with Candida auris in COVID-19 patients","volume":"13","author":"Janniger","year":"2021","journal-title":"World Medical and Health Policy"},{"key":"S0950268823001966_r7","first-page":"113","article-title":"Neurological manifestations in severe acute respiratory syndrome","volume":"14","author":"Tsai","year":"2005","journal-title":"Acta Neurologica Taiwanica"},{"key":"S0950268823001966_r17","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1186\/s12872-023-03322-8","article-title":"The long-term effects of the Covid-19 infection on cardiac symptoms","volume":"23","author":"Golchin Vafa","year":"2023","journal-title":"BMC Cardiovascular Disorders"},{"key":"S0950268823001966_r14","doi-asserted-by":"crossref","first-page":"698169","DOI":"10.3389\/fmicb.2021.698169","article-title":"Long COVID or post-acute sequelae of COVID-19 (PASC): an overview of biological factors that may contribute to persistent symptoms","volume":"12","author":"Proal","year":"2021","journal-title":"Frontiers in Microbiology"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268823001966","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T11:32:19Z","timestamp":1708687939000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268823001966\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,15]]},"references-count":20,"alternative-id":["S0950268823001966"],"URL":"https:\/\/doi.org\/10.1017\/s0950268823001966","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"type":"print","value":"0950-2688"},{"type":"electronic","value":"1469-4409"}],"subject":[],"published":{"date-parts":[[2023,12,15]]},"assertion":[{"value":"\u00a9 The Author(s), 2023. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e34"}}