Abstract
Currently, there are many questions around the real impact of COVID-19 at an organic level and the resolution of these is one of the main objectives of the scientific societies and public health institutions around the world, to establish the most effective and safe management protocol in the approach of this disease (Qureshi et al., 2020). Systematic reviews and meta-analyses mention that the common presentation of this entity is based on a syndromic picture, composed of fever, cough, asthenia, adynamia, myalgia and dyspnea (Rodriguez-Morales et al., 2020; Fu et al., 2020). However, other studies report that the initial presentation may debut with isolated pneumonia, sudden respiratory failure, myocardial injury, renal failure, encephalitis, or stroke (Zhao et al., 2020). Ischemic stroke is a condition of severe brain injury that leads to high rates of morbidity, mortality and disability, in addition to high economic costs in terms of diagnostic, therapeutic and rehabilitation intervention (Tan et al., 2020).
Highlights
It has been described that coronaviruses have tropism to the central nervous system, the pathophysiological mechanism of their involvement is not entirely clear up to date (Morassi et al, 2020)
The evidence of this tropism is controversial, because of the heterogeneity in the magnitude of deterioration found in the series of the evaluated cases (Rodriguez-Morales et al, 2020; Fu et al, 2020; Zhao et al, 2020), but clinical, laboratory, molecular and genetic findings have led to support that there is a clear tropism of coronaviruses to the central nervous system (Fan et al, 2020)
Given the findings of lymphopenia, prolonged prothrombin time, high lactate dehydrogenase levels, neutrophilia, increased levels of D-dimer, creatinine, creatine-phosphokinase and oxygen therapy requirement, it is suggested that these patients undergo a progressive and persistent state of inflammation, hypoxia and hypercoagulability (Fig. 1), which would explain the sudden presentation of fatal complications such as ischemic stroke, acute respiratory distress syndrome, septic shock, among others (Qureshi et al, 2020; Fan et al, 2020)
Summary
It has been described that coronaviruses have tropism to the central nervous system, the pathophysiological mechanism of their involvement is not entirely clear up to date (Morassi et al, 2020). The evidence of this tropism is controversial, because of the heterogeneity in the magnitude of deterioration found in the series of the evaluated cases (Rodriguez-Morales et al, 2020; Fu et al, 2020; Zhao et al, 2020), but clinical, laboratory, molecular and genetic findings have led to support that there is a clear tropism of coronaviruses to the central nervous system (Fan et al, 2020).
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