[Clinical and pathogenetic aspects of nervous system impairments in COVID-19]

Neurological manifestations are reported in 6-36% of patients with COVID-19. They could be divided into direct (viral), secondary (somatogenic) and post(para)infectious (autoimmune) variants according to the pathogenetic mechanisms of their development. The most common type is a secondary impairment of the nervous system presented with encephalopathy of hypoxic, infectious/toxic or dysmetabolic origin. Its major mechanism is related to the brain edema while clinical presentations include non-specific symptoms such as headaches, dizziness and consciousness impairments. Only single reports exist on coronavirus meningoencephalitides. Postinfectious complications of COVID-19 mostly presented with different forms of Gulliane-Barre syndrome. Stroke is registered in 2.5-5% of COVID-19 cases. Their development is associated with hypercoagulation and endothelial dysfunction. Strokes more often develop in elderly with established vascular risk factors and severe COVID-1 but they might also be observed in people younger than 50 years of age and in those with relatively mild forms of the disease. More research is needed in this area.