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COVID-19 and the nervous system.

Joseph R Berger^1,2

¹Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. joseph.berger@pennmedicine.upenn.edu.

Journal of Neurovirology

|May 25, 2020

Summary

The novel coronavirus (SARS-CoV-2) causes COVID-19, affecting the nervous system through direct invasion, autoimmune responses, or critical illness complications. This review examines reported neurological disorders and anticipates future findings based on similar viruses.

Keywords:

COVID-19 Coronavirus Encephalitis Meningitis Myositis Neurological complications SARS-CoV-2 Stroke

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Area of Science:

Neurology
Virology
Infectious Diseases

Background:

The COVID-19 pandemic, caused by SARS-CoV-2, emerged in late 2019.
SARS-CoV-2 shares genetic similarities with SARS-CoV-1, the virus responsible for the SARS epidemic.
Both viruses utilize spike proteins to bind to ACE-2 receptors, found in various tissues including the nervous system.

Purpose of the Study:

To review preliminary observations of neurological disorders associated with COVID-19.
To anticipate potential neurological complications based on prior experience with related coronaviruses.

Main Methods:

Review of preliminary observations and existing literature on COVID-19 neurological complications.
Comparative analysis with neurological manifestations of previous coronavirus epidemics (e.g., SARS).

Main Results:

Neurological complications are observed in COVID-19 patients, ranging from common symptoms like myalgia and headache to rarer, serious neurological diseases.
The neuraxis is susceptible to involvement, with potential pathophysiological mechanisms including direct viral invasion, postviral autoimmune processes, and systemic critical illness complications.

Conclusions:

COVID-19 can lead to a spectrum of neurological disorders with diverse underlying causes.
Understanding these neurological manifestations is crucial for managing patients and predicting outcomes, especially considering the virus's interaction with the ACE-2 receptor.