Neurologic Compromise in COVID-19: A Literature Review

Area of Science:

• Neurology
• Infectious Diseases
• Virology

Background:

• Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, presents with diverse neurological symptoms.
• Understanding these neurological manifestations and their pathogenesis is crucial for patient management.

Purpose of the Study:

• To systematically review and describe the reported neurological manifestations of COVID-19.
• To explore the probable pathogenic mechanisms underlying these neurological complications.

Main Methods:

• A comprehensive literature review was conducted.
• Databases searched included EMBASE, MEDLINE, and SCIELO.
• Keywords used were "COVID-19", "COVID", "neurological", "neurologic", "manifestations", "implications", "Guillain-Barre syndrome", and "encephalopathy".

Main Results:

• A total of 33 articles were reviewed, encompassing clinical series, retrospective studies, and case reports.
• Neurological manifestations of SARS-CoV-2 infection vary in clinical presentation, severity, and prevalence.
• Critical manifestations like cerebrovascular disease, encephalopathy, and Guillain-Barre syndrome were less frequent, often linked to pre-existing conditions or advanced age.

Conclusions:

• Hypothesized routes of viral spread include hematogenous dissemination, cribriform plate invasion, or cytokine storm.
• Recognizing neurological disturbances alongside laboratory alterations aids physicians in prompt diagnosis of SARS-CoV-2 neurological involvement.