Abstract
Objective: Review and integrate the neurologic manifestations of the Coronavirus Disease 2019 (COVID-19) pandemic, to aid medical practitioners who are combating the newly derived infectious disease.Methods: We reviewed the clinical research, consisting of mainly case series, on reported neurologic manifestations of COVID-19. We also reviewed basic studies to understand the mechanism of these neurologic symptoms and signs.Results: We included 79 studies for qualitative synthesis and 63 studies for meta-analysis. The reported neurologic manifestations were olfactory/taste disorders (35.6%), myalgia (18.5%), headache (10.7%), acute cerebral vascular disease (8.1%), dizziness (7.9%), altered mental status (7.8%), seizure (1.5%), encephalitis, neuralgia, ataxia, Guillain-Barre syndrome, Miller Fisher syndrome, intracerebral hemorrhage, polyneuritis cranialis, and dystonic posture.Conclusions: Neurologic manifestations in COVID-19 may alert physicians and medical practitioners to rule in high-risk patients. The increasing incidence of olfactory/taste disorders, myalgia, headache, and acute cerebral vascular disease renders a possibility that COVID-19 could attack the nervous system. The cytokine secretion and bloodstream circulation (viremia) are among the most possible routes into the nervous system.
Highlights
COVID-19 first occurred in late 2019 in Wuhan, China [1]
An increasing number of cases have presented with neurologic manifestations, such as olfactory and taste disorders [2], and the phenomenon requires further attention
The brain has been reported to express angiotensin-converting enzyme 2 (ACE2) receptors that have been detected over glial cells and neurons, which makes them a potential target of COVID-19
Summary
COVID-19 first occurred in late 2019 in Wuhan, China [1]. As of May 01, 2020, the COVID-19 pandemic had infected 3,291,008 worldwide and caused 232,478 deaths (data from the World Health Organization). Phylogenetic analysis of the complete viral genome revealed that the virus was most closely related (89.1% nucleotide similarity) to a group of SARS-like coronaviruses [3]. As such, it COVID-19 Neurologic Manifestations was previously termed SARS-CoV-2. The authors of a recent article [5] investigated the mechanism of COVID-19 nervous system involvement, and they stated that similar to SARS-CoV, the COVID-19 virus exploits the angiotensin-converting enzyme 2 (ACE2) receptor to gain entry inside the cells. The other research team used single-cell RNA-Seq datasets to suggest possible mechanisms through which CoV-2 infection could lead to anosmia or other forms of olfactory dysfunction [7]
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