Neurological manifestations and complications in patients with covid-19

Неврологические проявления и осложнения у пациентов с COVID-19
I. K. Ternovyh, M. P. Topuzova, A. D. Chaykovskaya, P. Sh. Isabekova, Т. М. Алексеева
2020-08-04

COVID-19 neurological complicationsGuillain–Barré syndromeSARS-CoV-2 nervous system invasioncentral and peripheral nervous systemmeningoencephalitis
It becomes apparent that the neurological complications of COVID-19 are significantly common, but in some cases, establishing a causal relationship is difficult. For example, a stroke can occur for reasons unrelated to coronavirus infection, while Guillain–Barré syndrome and meningoencephalitis are likely to be a parainfection. Only long-term epidemiological studies in large groups of patients can clarify some of these issues. This will help to better understand the mechanisms of development of complications and develop schemes for their treatment and subsequent rehabilitation. The article presents the mechanisms of penetration of the coronavirus into the nervous system and systematizes the neurological manifestations and complications of COVID-19, which were described in the first 3 months of the pandemic. Particular attention is paid to the consideration of the complications of COVID-19 from the central and peripheral nervous system, the most interesting clinical examples are considered. Summing up the analysis of the literature, we can say that the clinical picture of neurological diseases and syndromes caused by coronavirus infection corresponds to the usual notions. Also considered is the assumption that SARS-CoV-2 can persist for a long time in the central nervous system in the form of inactive fragments, which means that it can recur in predisposed individuals when appropriate conditions arise. This suggestion is alarming regarding distant neurological complications in infected and cured patients.
1
Long-term epidemiological studies are needed to clarify causality, mechanisms, treatment, rehabilitation, and possible delayed neurological complications, including those related to persistence of inactive viral fragments in the central nervous system.
2
Neurological complications of COVID-19 appear relatively common, although causality with SARS-CoV-2 is difficult to establish in some cases.
3
Reported COVID-19-related neurological diseases and syndromes generally correspond to established clinical presentations involving both the central and peripheral nervous systems.
4
Stroke may occur independently of coronavirus infection, whereas Guillain–Barré syndrome and meningoencephalitis are considered more likely to be parainfectious.
5
The article describes proposed mechanisms of SARS-CoV-2 entry into the nervous system and systematizes neurological manifestations reported during the first three months of the pandemic.

Neurological manifestations and complications of COVID-19, including central and peripheral nervous system involvement

Mechanisms of SARS-CoV-2 penetration and persistence in the nervous system, and the clinical spectrum and potential long-term neurological complications of COVID-19

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Publication Date
2020-08-04
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I. K. Ternovyh
M. P. Topuzova
A. D. Chaykovskaya
P. Sh. Isabekova
Т. М. Алексеева
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