Neurological manifestations of COVID-19: systemic review article / Монголын Анагаах Ухаан

ABSTRACT

Background@#Acute respiratory viral infection caused by human new coronavirus that was reported in last December of 2019, is becoming the most serious issue worldwide. During human coronavirus infection, upper and lower respiratory symptoms are common. However, other systemic symptoms, especially neurological signs were reported previously. It is further noted that sometimes the neurological manifestations can precede the typical features like fever and cough and later on typical manifestations develop in these patients. Purpose: to analyze information of neurological manifestations related to COVID-19 disease and possible way of affection of nervous system by SARS-CoV-2 virus.@*Material and Methods@#We searched Medline, PubMed, Central and Google Scholar, Web of Science for related published articles and case reports, using keywords such as “COVID-19”, “Coronavirus”, “pandemic”, “SARS-CoV-2”, “Neurological manifestations”; “Complications”; “Clinical characteristics”. There were found and considered few articles of clinical characteristics and case series reports related to COVID-19 with neurological manifestations and complications, also articles of SARS-CoV-2 virus affection to nervous system.@*Results@#Neurological manifestations including headache, dizziness, myalgia, confusion, and hyposmia were observed during COVID-19 in 6-36.4% cases. A few cases with COVID-19 showed more severe symptoms such as stroke, polyneuropathy, encephalopathy, myelitis and acute necrotizing encephalitis. SARS-CoV-2 viral infection pathway may be two different ways, namely, a) binding ACE-2 receptor on capillary endothelium and causing inflammation where then can cross blood-brain barrier and to emerge brain tissue damage; b) entering via nasal epithelium where the bipolar cells locate, from there directs to central nervous system to cause neuronal injury through olfactory bulb. </br> Conclusion: neurological manifestations are relatively common in COVID-19, however, there is lack of evidence-based study. There may have two possible pathways of SARS-CoV-2 to affect nervous system, but is required necessary further elaborately study