A brief review of the neurological manifestations of the coronavirus disease

Abstract

Introduction It has been demonstrated experimentally that the coronavirus can enter the central nervous system through olfactory nerves and can even reach medulla. Neurological manifestations are observed more frequently in patients with coronavirus disease. Main text The aim of the review is to seek evidence for infection of the nervous system by the human coronavirus and study the neurological manifestations of the coronavirus and its treatment. A search was done in PubMed, Google Scholar, CrossRef, and Scopus. There is evidence for the coronavirus infection of the nervous system from experimental studies, autopsy reports, and clinical studies. The virus can damage the nervous system either by direct viral damage to the neural cells or by immunopathology. Cerebral edema, neuronal degeneration, encephalitis, meningoencephalitis, acute disseminated encephalomyelitis, Guillain–Barré Syndrome, Bickerstaff’s brainstem encephalitis, Miller Fisher syndrome, polyneuritis, toxic encephalopathy, and stroke can occur. The coronavirus has been demonstrated in the cerebrospinal fluid by polymerase chain reaction technique in infected patients. The abnormalities of the coagulation system increase the risk of cerebrovascular disease. Chloroquine analogs, lopinavir/ritonavir combination, remdesivir, dexamethasone, and immunoglobulin have been shown to be useful for the treatment. Conclusion There is substantial evidence for infection of the nervous system by the different strains of the human coronavirus. The coronavirus enters the nervous system either by the blood or from the olfactory nerves. The neurological diseases correlate with the severity of the coronavirus disease. The treatment is mainly supportive. The reports of patients with encephalitis, encephalomyelitis, and brainstem encephalitis show slow recovery. But a stroke has a high mortality.

Encephalitis as a neurological complication of COVID‐19: A systematic review and meta‐analysis of incidence, outcomes, and predictors

“…Notably, we found that the most common form of encephalitis in COVID‐19 is autoimmune encephalitis [9,21,24,30,33]. There have also been reports of acute haemorrhagic necrotising encephalopathy [48] and Guillain–Barré syndrome [49] which are known to develop via molecular mimicry, further supporting the theory of molecular mimicry as the pathophysiology of encephalitis as a complication of COVID‐19. Overall, primary data from COVID‐19 patients with encephalitis remains limited, hence conclusions regarding the mechanistic properties and pathophysiology of encephalitis in COVID‐19 cannot be drawn at present.…”

Neurološke komplikacije COVID-19

“…Iste promjene s hipometabolizmom moždanog debla i talamusa su uočene u fazi nakon COVID-19 kod bolesnika s kognitivnim smetnjama trajanja dužeg od 3 tjedna. U sljedećoj studiji (8 bolesnika u subakutnoj i kroničnoj post-COVID-19 fazi) uočene su slične promjene na PET-FDG obostrano fronto-parijetalno koje su se povukle nakon 6 Bol u mišićima i mišićna slabost se često javljaju kod hospitaliziranih, ali i kod ambulantnih bolesnika s COVID-19, a učestalost pojavljivanja varira u pojedinim izvještajima i kreće se od 20-50% [9,60] . Poznato je da i druge virusne bolesti kao što je npr.…”

“…poremećajima te vaskularnim oštećenjima koji rezultiraju neurološkom bolešću [8] . Imunološki odgovori domaćina pokrenuti za vrijeme ili nakon virusnih infekcija također mogu rezultirati autoimunim oštećenjem živčanog tkiva što je slučaj u primjerima Guillain Barré-ovog sindroma (GBS), akutnog diseminiranog encefalomijelitisa (ADEM) ili akutnog transverzalnog mijelitisa (ATM) [9] .…”

Dialogue between Neuroinflammation and Neurodegenerative Diseases in COVID-19

“…[17][18][19][20] To confirm the above notion reports from various hospitals show that many patients of COVID-19 suffered from encephalitis, anosmia, acute cerebrovascular disease, and Guillain-Barre syndrome (GBS). [21][22][23][24] This implies that SARS-CoV-2 can cause numerous complications in the brain. Therefore, this review aims at examining all the possibilities of the virus entering the CNS, interacting with neurons and glia, causing neuroinflammation and the neurodegenerative disorders connected with COVID-19.…”