Neurotropism and Neuropsychiatric Symptomsi in Patients with COVID-19

The Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2). Beyond the most common clinical features of COVID-19, mainly represented by respiratory symptoms, other systems may be interested by the infection. Among these, through a neurotropic pathway, the central nervous system (CNS) may be affected by the virus, leading to developing neuropsychiatric symptoms. Particularly, this study focuses on neurological symptoms determined by the Sars-CoV-2 infection, as well as on the underlying pathogenetic processes.

For the present review, we followed a narrative approach. A literature search was carried out concerning the neurological consequences of COVID-19. Papers were screened, focusing on the clinical manifestations interesting the CNS and on their possible role in the early diagnosis of the disease.

We display the most significant neurological clinical manifestations of COVID-19. Common neurological manifestations (ageusia, anosmia, and encephalitis) are first described. Subsequently, we provide a focus on delirium and its possible pathogenetic and clinical correlates. Delirium is not only a possible resultant of the COVID-19 neurotropism, but it may also be precipitated by a number of environmental factors that assume further relevance during the pandemic.

Neuropsychiatric symptoms, and particularly delirium, can help identifying the infection at an early stage. Tailored treatments should be identified in order to prevent complications.