Potential neurological manifestations of COVID-19: a narrative review

ABSTRACT

Neurological manifestations are increasingly reported in a subset of COVID-19 patients. Previous infections related to coronaviruses, namely Severe Acute Respiratory Syndrome (SARS) and Middle Eastern Respiratory Syndrome (MERS) also appeared to have neurological effects on some patients. The viruses associated with COVID-19 like that of SARS enters the body via the ACE-2 receptors in the central nervous system, which causes the body to balance an immune response against potential damage to nonrenewable cells. A few rare cases of neurological sequelae of SARS and MERS have been reported. A growing body of evidence is accumulating that COVID-19, particularly in severe cases, may have neurological consequences although respiratory symptoms nearly always develop prior to neurological ones. Patients with preexisting neurological conditions may be at elevated risk for COVID-19-associated neurological symptoms. Neurological reports in COVID-19 patients have described encephalopathy, Guillain-Barré syndrome, myopathy, neuromuscular disorders, encephalitis, cephalgia, delirium, critical illness polyneuropathy, and others. Treating neurological symptoms can pose clinical challenges as drugs that suppress immune response may be contraindicated in COVID-19 patients. It is possible that in some COVID-19 patients, neurological symptoms are being overlooked or misinterpreted. To date, neurological manifestations of COVID-19 have been described largely within the disease trajectory and the long-term effects of such manifestations remain unknown.

KEYWORDS:

• Coronavirus
• COVID-19
• MERS
• neurological symptoms
• SARS

Acknowledgments

This article is based on previously conducted studies and does not contain any studies with human participants or animals performed by any of the authors. No funding or sponsorship was received for this study or publication of this article.

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None of the authors has any relevant financial disclosures or conflicts of interest.

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The other authors on the manuscript have no relevant disclosures.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

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