Serious and infrequent neurological complications in hospitalized patients with COVID19

SARS-CoV-2 virus infection may affect other organs including the nervous system with variable neurological manifestations, even some research has reported that SARS-CoV-2 can be found in the brain parenchyma and / or in the cerebrospinal fluid (CSF). Although these reports of neurological involvement secondary to COVID-19 has increased, the clinical manifestations and the forms of neurological invasion is not fully understood.

In this paper, we report a case series of patients with SARS-CoV-2 infection with involvement of the nervous system and its neurological complications. In addition, a bibliographic review was developed in different databases with the aim of expanding information on neurological complications and the pathophysiological mechanisms of invasion to the nervous system.

Case 1, a 79 year old male developed an infarct of the head of the caudate nucleus and thrombosis of the superior longitudinal sinus. Case 2, a 62 year old female developed an intraparenchymal hemorrhage in the left parietal lobe while hospitalized and COVID19 encephalitis was diagnosed. Case 3, a 59 year old healthy male developed a Fisher IV subarachnoid hemorrhage by aneurysmal origin of the right middle cerebral artery and right temporal intraparenchymal hematoma, due to rapid and severe neurological impairment new brain images was performed showing a right cerebellar ischemic stroke leading to compression of the cistern and brainstem.

In these cases, the surgery goal was relieved symptoms, neurologic functional recovery, and life survival. We considered its diffusion and knowledge as imperative for all practitioners involved in the care of this patient.