Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and was first identified in Wuhan, China in December 2019. It is evident that the COVID-19 pandemic has become a challenging world issue. Although most COVID-19 patients primarily develop respiratory symptoms, an increasing number of neurological symptoms and manifestations associated with COVID-19 have been observed. In this narrative review, we elaborate on proposed neurotropic mechanisms and various neurological symptoms, manifestations, and complications of COVID-19 reported in the present literature. For this purpose, a review of all current published literature (studies, case reports, case series, reviews, editorials, and other articles) was conducted and neurological sequelae of COVID-19 were summarized. Essential and common neurological symptoms including gustatory and olfactory dysfunctions, myalgia, headache, altered mental status, confusion, delirium, and dizziness are presented separately in sections. Moreover, neurological manifestations and complications that are of great concern such as stroke, cerebral (sinus) venous thrombosis, seizures, meningoencephalitis, Guillain–Barré syndrome, Miller Fisher syndrome, acute myelitis, and posterior reversible encephalopathy syndrome (PRES) are also addressed systematically. Future studies that examine the impact of neurological symptoms and manifestations on the course of the disease are needed to further clarify and assess the link between neurological complications and the clinical outcome of patients with COVID-19. To limit long-term consequences, it is crucial that healthcare professionals can early detect possible neurological symptoms and are well versed in the increasingly common neurological manifestations and complications of COVID-19.
Highlights
On March 11, 2020, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) to be a world pandemic
Moriguchi and colleagues first reported the presence of SARS-CoV-2 RNA in the cerebrospinal fluid (CSF) of a patient with encephalopathy and COVID-19 using real-time reverse transcription PCR (RT-PCR) [7]
Further cases have since been reported [8–10], SARS-CoV-2 was not detected in the CSF of most COVID-19 patients with neurological manifestations [11, 12]
Summary
On March 11, 2020, the World Health Organization (WHO) declared the coronavirus disease 2019 (COVID-19) to be a world pandemic. COVID-19 is caused by the recently identified severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) and is an ongoing global health emergency [1]. As of January 10, 2021, there are 90.08 million confirmed cases of COVID-19 globally in 218 countries and over 1.93 million deaths (https://www.worldometers.info/ coronavirus/). 64.46 million subjects have recovered throughout the world, pointing to a recovery rate of around 97%. Most patients with COVID-19 present with mild respiratory illness such as dry cough, fever, and dyspnea.
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