COVID-19 and SARS-Cov-2 Infection: Pathophysiology and Clinical Effects on the Nervous System.

Abstract

Coronavirus disease 19 (COVID-19) is an infectious disease caused by SARS-Cov-2, resulting in severe acute respiratory syndrome, with high potential of spreading and infecting humans worldwide. Since January 2020, when the virus was identified in humans, the literature on COVID-19 has grown exponentially, and extra respiratory symptoms including neurological symptoms are increasingly highlighted.

These neurological disorders are grouped into several categories, ranging from non-specific and moderate symptoms such as headache, myalgia and hyposmia to severe symptoms including cerebrovascular disease and intracranial infections. Severe neurological symptoms such as acute cerebrovascular disease occur only in a minority of patients with usual risk factor, and are associated with poor outcome. However, most COVID-19 patients exhibit only minor or mild neurological symptoms.

Given the high and increasing number of publications reporting neurological involvements of SARS-Cov-2, we think providing an update for neurological complications of COVID-19 could be useful for physician and especially young trainees in neurology and neurosurgery. Indeed, in this review we discuss several neurological aspects reported in the literature to date, including the evidence and pathways of the neuro-invasion in COVID-19, and the main neurological disorders reported in the literature to date, as well as the future perspectives and the potential long term consequence of current neuro-infection in COVID-19 patients.