Pathophysiological Mechanisms and Neurological Manifestations in COVID-19

Area of Science:

• Neurology
• Infectious Diseases
• Critical Care Medicine

Background:

• Coronavirus disease-2019 (COVID-19) is known to cause extrapulmonary manifestations, including central nervous system (CNS) involvement.
• Neurological symptoms can occur through various mechanisms, including direct viral spread, hypoxia, immune responses, and vascular damage.
• Understanding these mechanisms is vital for managing patients with COVID-19 and neurological complications.

Purpose of the Study:

• To review the pathophysiological mechanisms underlying CNS involvement in COVID-19.
• To discuss common and significant neurological manifestations associated with COVID-19.
• To highlight the importance of recognizing neurological symptoms for early diagnosis and management.

Main Methods:

• This is a review article, synthesizing existing knowledge on COVID-19 and neurological involvement.
• Information was gathered from relevant scientific literature and clinical observations.
• The review focuses on established and emerging understanding of pathogenesis and clinical presentations.

Main Results:

• Neurological manifestations of COVID-19 are common and diverse, including headache, dizziness, chemosensory loss, encephalopathy, and stroke.
• Headache is a key red flag symptom, and sudden loss of smell/taste without congestion aids in case identification.
• Both ischemic and hemorrhagic strokes are observed, necessitating vigilance, especially in patients with pre-existing neurological conditions.

Conclusions:

• Neurological involvement in COVID-19 is not uncommon and can manifest before, during, or after respiratory symptoms, or even as the sole presentation.
• High vigilance for COVID-19 is required, particularly in patients presenting with neurological symptoms.
• Further research into the specific mechanisms and long-term neurological effects of COVID-19 is warranted.