Abstract
Most of what we know about the coronavirus disease 2019 (COVID-19) is limited to what we know about severe acute respiratory syndrome (SARS) and COVID-19's epidemiology, fatality, and acute care. However, infection with COVID-19 may also involve the central nervous system (CNS), which may or may not be due to a multi-organ injury. Our aim in this paper is to briefly summarize the main aspects of the growing literature on neurological manifestations of the COVID-19 infection. As such, after mentioning some general background on the economic and medical implications of the pandemic on individuals, the healthcare system, and the society, we summarize some common aspects of the published literature on neurological manifestations of the COVID-19 infection. We also highlight the existing gaps in the literature, which requires additional work. The most common neurological manifestation of COVID-19 infection is an olfactory deficit. However, it is still unknown if it is inflammatory or degenerative in nature. Still, the incidence of neurological complications, and also their mechanisms and treatments are unknown. This literature is predominantly composed of opinions and reviews rather than original articles, so the patients' data are not used for a majority of the studies. Multi-center studies that not only conduct chest CT or MRI but also brain CT or MRI are needed. Randomized trials are still required on the management of acute and chronic neurological conditions due to COVID-19 infection. Cohort studies may also determine the natural history of the conditions and factors that are prognostic. Furthermore, while disparities in COVID-19 infections are known, inequalities in neurological manifestations are unknown. Besides this, the efficacy of specific treatments on CNS involvement is still unknown. We will discuss the health care needs of patients with chronic neurological conditions. We Included a few recommendations for practice and further research at the end of this paper.
Highlights
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), has generated a full-blown global pandemic in 2020.1,2 By July 2020, there have been 15 million confirmed cases of COVID-19, which includes more than six hundred thousand deaths, reported by the World Health Organization (WHO).[3]
The current paper first reviews some general aspects of the pandemic and summarizes the literature which has been published on neurological manifestations of the COVID-19
This paper aims to add to the ever-emerging landscape of medical knowledge on COVID-19, encapsulating its multi-organ impact
Summary
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2), has generated a full-blown global pandemic in 2020.1,2 By July 2020, there have been 15 million confirmed cases of COVID-19, which includes more than six hundred thousand deaths, reported by the World Health Organization (WHO).[3]. Based on our current knowledge, severe neurologic conditions (e.g., acute cerebrovascular disease) are rare and only occur in a minority of patients who have multiple risk factors. These severe types of neurological involvement are commonly associated with poor outcomes. The medications used by patients with multiple sclerosis may increase the risk of COVID-19 infection as well as undesired outcomes.[45] Research in this area is mainly case series and case reports. Healthcare providers need to assume that patients with chronic neurological diseases such as bulbar/respiratory muscle weakness (e.g., myasthenia gravis or Lambert Eaton myasthenic syndrome) are at higher risk of contracting the infection or experiencing severe manifestations of COVID-19.
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