COVID-19 Pandemic and Neurological Disease: A Critical Review of the Existing Literature.

ABSTRACT

Most of what we know about the coronavirus disease 2019 (COVID-19) is limited to what we know about severe acute respiratory syndrome (SARS) and COVID-19's epidemiology, fatality, and acute care. However, infection with COVID-19 may also involve the central nervous system (CNS), which may or may not be due to a multi-organ injury. Our aim in this paper is to briefly summarize the main aspects of the growing literature on neurological manifestations of the COVID-19 infection. As such, after mentioning some general background on the economic and medical implications of the pandemic on individuals, the healthcare system, and the society, we summarize some common aspects of the published literature on neurological manifestations of the COVID-19 infection. We also highlight the existing gaps in the literature, which requires additional work. The most common neurological manifestation of COVID-19 infection is an olfactory deficit. However, it is still unknown if it is inflammatory or degenerative in nature. Still, the incidence of neurological complications, and also their mechanisms and treatments are unknown. This literature is predominantly composed of opinions and reviews rather than original articles, so the patients' data are not used for a majority of the studies. Multi-center studies that not only conduct chest CT or MRI but also brain CT or MRI are needed. Randomized trials are still required on the management of acute and chronic neurological conditions due to COVID-19 infection. Cohort studies may also determine the natural history of the conditions and factors that are prognostic. Furthermore, while disparities in COVID-19 infections are known, inequalities in neurological manifestations are unknown. Besides this, the efficacy of specific treatments on CNS involvement is still unknown. We will discuss the health care needs of patients with chronic neurological conditions. We Included a few recommendations for practice and further research at the end of this paper.