Abstract
The Coronavirus Disease 2019 (COVID-19) outbreak has shocked the whole world with its unexpected rapid spread. The virus responsible for the disease, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), enters host cells by means of the envelope spike protein, which binds to angiotensin-converting enzyme 2 receptors. These receptors are highly expressed in heart, lungs, respiratory tract epithelium, endothelial cells and brain. Since an increasing body of significant evidence is highlighting a possible neuroinvasion related to SARS-CoV-2, a state of the art on the neurological complications is needed. To identify suitable publications, our systematic review was carried out by searching relevant studies on PubMed and Scopus databases. We included studies investigating neurologic manifestations of SARS-CoV-2 in patients over 18. According to the analyzed studies, the most frequent disorders affecting central nervous system (CNS) seem to be the following: olfactory and taste disorders, ischemic/hemorrhagic stroke, meningoencephalitis and encephalopathy, including acute necrotizing encephalopathy, a rare type of encephalopathy. As regards the peripheral nervous system (PNS), Guillain-Barré and Miller Fisher syndromes are the most frequent manifestations reported in the literature. Important clinical information on the neurological manifestations of SARS-CoV-2 would help clinicians raise awareness and simultaneously improve the prognosis of critically ill patients.
Highlights
Since it was first announced in December 2019 in Wuhan, China, the Coronavirus Disease
Genomic analyses showed that the virus responsible for COVID-19, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), belongs to a beta-coronavirus cluster, along with the SARS-CoV and the Middle East
The purpose of the present study was to provide a systematic review of the literature, gathering relevant studies on the neurologic complications of COVID-19 on both the central nervous system (CNS) and the peripheral nervous system (PNS) in order to enhance a better management of infection-related neurological complications of affected patients
Summary
Since it was first announced in December 2019 in Wuhan, China, the Coronavirus Disease. Organization (WHO) declared COVID-19 as a pandemic disease [1]. Genomic analyses showed that the virus responsible for COVID-19, the Severe Acute Respiratory Syndrome Coronavirus 2. Respiratory Syndrome Coronavirus (MERS-CoV) [2]. Infection in humans often leads to severe clinical symptoms and high mortality [3]. Clinical manifestations include respiratory symptoms and gastroenteric symptoms, with an incubation time ranging from two days to two weeks [4]. Clinical characteristics of COVID-19 observed far are fever, dry cough, diarrhea, fatigue, dyspnea and pneumonia with peculiar lungs radiological features, such as bilateral multiple lobular and subsegmental areas of consolidations. Its severity ranges from asymptomatic manifestation to death [5]. Much is known about the mortality rate and the main clinical manifestations
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