Nervous system affections in coronavirus infection COVID-19

Abstract

In this review, we present available data on the nervous system involvement in coronavirus infection COVID‑19. There is provided a summarized information on neuroinvasiveness and potential neurovirulence of the coronavirus infection, the ways for infecting the nervous system, possible pathogenetic mechanisms, the clinical and diagnostic characteristics of the central and peripheral nervous system damage, there are also outlined prognostic prospects.Nervous system affections in coronavirus infection COVID‑19 can occur both as a result of the direct effect of the virus, and indirectly, in particular, with inadequate activity of the immune mechanisms, under the influence of hypoxia, infectious intoxication factors, changes in the hemostatic system, etc. Neurological symptoms are quite common in COVID‑19, in particular headache, general weakness, dizziness, anosmia, and the like. Such neurological manifestations in COVID‑19 as encephalitis, meningoencephalitis, acute hemorrhagic necrotizing encephalopathy, acute cerebrovascular disorders, microhemorrhage, diffuse leukoencephalopathy, Guillain‑Barr syndrome, myoclonus, Miller Fischer syndrome, polyneuritis with cranial nerve injury, skeletal muscle damage are also described. It is important to emphasize that neurological manifestations of COVID‑19 may precede the other clinical presentations of the disease, including respiratory manifestations and hyperthermia. The already‑existing infection of the central nervous system with the specific RNA SARS‑CoV‑2 in the cerebrospinal fluid is possible to be in case of the negative PCR nasopharyngeal swab result. There is given a validated information about SARS‑CoV‑2 neuroinvasiveness and neurovirulence. Taking the foregoing into consideration, we suggest envisaging the prognostic prospects for the development of chronic COVID‑19‑associated neurological pathology, which prevalence and manifestations will depend on the ratio of a large number of factors, including genetic determinism, adaptive and compensatory reserve of the organism in general and the nervous system in particular, already‑existing neurological pathologies, comorbidities, the condition and features of immune functions, etc.