Neurological implications of COVID-19: a review of the science and clinical guidance

Abstract

COVID-19 is a significant global health burden. The pulmonary morbidity and mortality of COVID-19 is well described, however, there is mounting evidence of neurological manifestations of SARS-CoV-2, which may be of prognostic significance. This paper summarises the available evidence in order to provide clinicians with a concise summary of the peripheral and central neurological manifestations of COVID-19, discusses specific issues regarding the management of chronic neurological disease in the context of the pandemic, and provides a summary of the thrombotic implications of the disease for the neurologist.

Bilateral paralysis of peroneal nerve after COVID-19 disease: a case report

“…Tan et al noted the existence of post-infection fatigue and cognitive 'fog' after the infection. What is more, postviral fatigue is characteristic for other viral infections, including the coronaviriade such as SARS [ 20 ]. Although some correlations between COVID-19 and these neurological symptoms are still unclear, we have to remember that they often accompany patients for months after discharge from the hospital, decreasing the quality of their life.…”

Drugs that offer the potential to reduce hospitalization and mortality from SARS-CoV-2 infection: The possible role of the sigma-1 receptor and autophagy

“…SARS-CoV-2 can impact the CNS, thereby leading to ischemic stroke, manifested by raised inflammatory markers and endothelial dysfunction [7][8][9]. Encephalopathy, encephalitis, acute demyelinating encephalomyelitis with and without hemorrhage, and transverse myelitis are also reported CNS syndromes [4]. Guillain-Barre syndrome (GBS), brachial plexopathy, polycranial neuropathies, and myopathies are reported syndromes in the CNS [2,6].…”

“…Researchers are finding evidence of neurological manifestations of SARS-CoV-2, which may be of prognostic significance [ 4 ]. A recent study of 236 379 patients diagnosed with SARS-CoV-2 infection showed that there was a significant increase in risk of developing a neurological disease in the following six months after infection.…”

“…These diseases identified included intracranial hemorrhage, ischemic stroke, parkinsonism, dementia, anxiety and mood disorders, and other psychiatric conditions [ 5 ]. The neuropathological effects of SARS-CoV-2 infection majorly constitute (i) direct viral injury, (ii) neural or vascular pathology arising secondary to a hyperinflammatory state, (iii) vasculopathy/coagulopathy, (iv) post-infectious autoimmune, and (v) neurological consequence of severe illness (sepsis, hypoxia) [ 4 , 6 ], which can affect both central as well as the peripheral nervous system. However, the evidence so far suggests that the neurological diseases developed after the infection might be because of the reactions inside the body and not by the direct invasion of virus into the nervous system [ 3 , 7 ].…”

Global Publications on Covid-19 and Neurosciences: A Bibliometric Assessment during 2020-21

“…Examples of (i) Central Nervous System neurological manifestations include dizziness, headache, cerebrovascular disease, encephalopathy/delirium, encephalitis, acute disseminated encephalomyelitis, acute necrotising hemorrhagic encephalopathy, seizures, ischemic stroke, intra-cerebral hemorrhage, encephalo-myelitis, and acute myelitis and (ii) peripheral nervous system include hypoguesia and hyposmia, Guillain-Barre syndrome, myalgia, Bell's palsy, Brachial plexopathy and skeleton muscle manifestations such as rhabdomyolysis. 5,6 Literature Review Although a number of bibliometric studies have been undertaken on Coronavirus and Covid-19 research, 7,8 but only few bibliometric studies exists in neurological implications of Covid-19. Among available…”