Neurological and Neuropsychiatric Impacts of COVID-19 Pandemic

Abstract

Background: Albeit primarily a disease of respiratory tract, the 2019 coronavirus infectious disease (COVID-19) has been found to have causal association with a plethora of neurological, neuropsychiatric and psychological effects. This review aims to analyze them with a discussion of evolving therapeutic recommendations. Methods: PubMed and Google Scholar were searched from 1 January 2020 to 30 May 2020 with the following key terms: “COVID-19”, “SARS-CoV-2”, “pandemic”, “neuro-COVID”, “stroke-COVID”, “epilepsy-COVID”, “COVID-encephalopathy”, “SARS-CoV-2-encephalitis”, “SARS-CoV-2-rhabdomyolysis”, “COVID-demyelinating disease”, “neurological manifestations”, “psychosocial manifestations”, “treatment recommendations”, “COVID-19 and therapeutic changes”, “psychiatry”, “marginalised”, “telemedicine”, “mental health”, “quarantine”, “infodemic” and “social media”. A few newspaper reports related to COVID-19 and psychosocial impacts have also been added as per context. Results: Neurological and neuropsychiatric manifestations of COVID-19 are abundant. Clinical features of both central and peripheral nervous system involvement are evident. These have been categorically analyzed briefly with literature support. Most of the psychological effects are secondary to pandemic-associated regulatory, socioeconomic and psychosocial changes. Conclusion: Neurological and neuropsychiatric manifestations of this disease are only beginning to unravel. This demands a wide index of suspicion for prompt diagnosis of SARS-CoV-2 to prevent further complications and mortality.

Possible Autoimmune Encephalitis with Claustrum Sign in case of Acute SARS-CoV-2 Infection

“…neuropathogenesis is autoimmune, which would align with steroid responsiveness. The finding of the claustrum sign on brain MRI, not previously reported in a COVID-19 patient, [4][5][6][7][8] provides further support for the idea that acute SARS-CoV-2 infection may present as an autoimmune encephalitis.…”

Autonomic dysfunction heralding acute motor axonal neuropathy in COVID-19

“…Physicians are seeing increasingly more patients with a spectrum of neurological manifestations associated with coronavirus disease 2019 (Ghosh et al 2020;Gutiérrez-Ortiz et al 2020;Rábano-Suárez et al 2020;Roy et al 2020). However, the pathogenesis of COVID-19-induced neurological manifestations is still in its infancy.…”

“…Discussion SARS-CoV-2 has potential for neurotropism (Li et al 2020;Rábano-Suárez et al 2020;Roy et al 2020). Study with animal models have demonstrated that SARS-CoV and MERS-CoV, possibly via olfactory nerves, can spread rapidly inside central nervous system, thalamus and brainstem in particular (Li et al 2020).…”

Concomitant Guillain-Barre syndrome with COVID-19: a case report

“…Neurological outcomes in patients with COVID-19 have been reported [5]. The neurological manifestations range from headache, dizziness, confusion, to in a few cases, more severe conditions, such as encephalopathy, acute disseminated encephalomyelitis and GBS, among others [6].…”