SARS-CoV-2 and Nervous System - Neurological Manifestations in Patients With COVID-19: A Systematic Review

Area of Science:

• Neurology
• Infectious Diseases
• Virology

Background:

• Coronavirus (CoV) infections present a wide range of symptoms, from asymptomatic cases to severe pneumonia.
• Neurologic symptoms associated with CoV infections have been increasingly reported.
• The precise relationship between SARS-CoV-2 and the central nervous system (CNS) remains unclear.

Purpose of the Study:

• To review current knowledge on central nervous system (CNS) manifestations in patients with SARS-CoV-2 infection.
• To identify specific characteristics of COVID-19 in patients with CNS involvement.

Main Methods:

• A systematic literature review was conducted using the PubMed database.
• Searched for articles published between January 1, 2020, and April 30, 2020.
• Included retrospective studies and case reports/series focusing on CNS involvement; excluded reviews, letters, and studies on specific populations or factors.

Main Results:

• 16 studies (3 retrospective, 13 case reports/series) were included in the review.
• Severe COVID-19 illness is associated with greater CNS involvement, including neurological symptoms like dizziness and headache.
• Severe cases showed an association with strokes and higher levels of D-dimer and C-reactive protein, alongside multi-organ damage.

Conclusions:

• Patients with severe SARS-CoV-2 infections are more prone to central nervous system (CNS) complications.
• Neurological symptoms and cerebrovascular events like strokes are observed in severe COVID-19.
• Further research is needed to fully elucidate the CNS manifestations and mechanisms in SARS-CoV-2 infection.