Neurologic Manifestations of Severe Acute Respiratory Syndrome Coronavirus 2 Infection

Abstract

PURPOSE OF REVIEW: This article describes the spectrum of neurologic complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, their underlying pathology and pathogenic mechanisms, gaps in knowledge, and current therapeutic strategies.RECENT FINDINGS: COVID-19 is the clinical syndrome caused by the novel coronavirus SARS-CoV-2. It can affect the entire neuraxis, and presentations in the acute phase are variable, although anosmia is a common manifestation. Encephalopathy is common in patients who are hospitalized and is often associated with multiorgan involvement. Immune-mediated encephalitis is probably underrecognized; however, viral encephalitis is rare. Other manifestations include stroke, seizures, myelitis, and peripheral neuropathies, including Guillain-Barré syndrome, which sometimes has atypical manifestations. Treatment is symptomatic, and immunotherapies have been used successfully in some patients. Long-term complications include dysautonomia, exercise intolerance, malaise, sleep disturbances, cognitive impairment, and mood disorders. SUMMARY: Neurologic manifestations of COVID-19 may occur in the acute setting and may be independent of respiratory manifestations. Immune-mediated syndromes and cerebrovascular complications are common. Large populations of patients are expected to have long-term neurologic complications of COVID-19, many of which may emerge only after recovery from the acute illness.

The cognitive and psychiatric subacute impairment in severe Covid-19

“…Necropsic studies have proven some neuroinvasive capacity of SARS-CoV-2 7 , 10 , 11 . This virus may enter the brain through three potential mechanisms: transsynaptic spread from the olfactory bulb following intranasal exposure, migration across the BBB through endothelial cell infection, and migration following disruption of the BBB from resulting inflammation 12 – 14 . Pathologic studies have found a high prevalence of SARS-CoV2 RNA and surface protein structures in olfactory mucosa 11 .…”

Neuromuscular complications after COVID-19 vaccination: a series of eight patients

“…Since the beginning of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, several neurologic complications have been described, both as parainfectious (e.g., stroke, viral encephalitis) and postinfectious (e.g., myelitis) phenomena [ 1 ]. In addition, neuromuscular complications in close temporal relation with coronavirus disease-2019 (COVID-19) have been reported, the most frequent being Guillain-Barré syndrome (GBS) [ 2 ].…”

Longitudinally extensive transverse myelitis (LETM) secondary to SARS‐CoV‐2 infection: A recent reality in spinal cord injury rehabilitation

“… 1 It is essential to recognize neurological involvement in COVID‐19, some of which require urgent intervention. 1 Transverse myelitis (TM) is one of the possible disorders associated with COVID‐19, with few cases described in the literature. 1 , 2 , 3 , 4 However, like other causes of spinal cord injury (SCI), management of complications must not be disregarded.…”

“… 1 Transverse myelitis (TM) is one of the possible disorders associated with COVID‐19, with few cases described in the literature. 1 , 2 , 3 , 4 However, like other causes of spinal cord injury (SCI), management of complications must not be disregarded. Most case reports do not include the rehabilitation and the reality of the process after hospital discharge.…”