Neurological Manifestations of SARS-CoV-2 Infection and the Role of Complement Activation

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, while considered a respiratory illness, is associated with a wide range of neurological manifestations, with severity ranging from transient deficit to permanent disability and death. These neurological manifestations can be divided into central nervous system complications, which include cerebrovascular disease and encephalopathies, and peripheral nervous system complications, which involve the muscle (i.e. muscle injuries, myositis, and peripheral and cranial neuropathies). Complement overactivation has been observed clinically in many studies and is hypothesized to be involved in a variety of pathogenic mechanisms of SARS-CoV-2 infection. These include endothelial damage, thrombosis and hyperinflammation, all of which are completely interconnected and integrated. This article broadly describes the diverse neurological effects of coronavirus disease 2019 and delves into the current literature available on complement in this context.