Neurological Complications and Consequences of the Novel Coronavirus COVID-19 Infection in Elderly and Senile Patients (Literature Review)

Abstract

Based on available publications, the article systematizes information about some forms of lesions of the central nervous system (CNS), their pathogenesis and clinical manifestations in the case of COVID-19. The risk factors, mechanisms of development, diagnostic approach, and the age characteristics of patients with neurological complications of COVID-19 are discussed. The specific mechanisms of the neuroinvasiveness and neurovirulence of the SARS-CoV-2 virus, regardless of the age of patients and the presence of risk factors, lead to systemic damage to the endothelium of small-caliber vessels, generalized thrombovasculitis, and an increased risk of ischemic and hemorrhagic strokes. At the same time, the most vulnerable category is elderly and senile patients with cardiovascular and metabolic disorders (arterial hypertension, obesity, diabetes mellitus), which sharply worsen treatment outcomes. The clinical experience accumulated during the COVID-19 pandemic indicates the development of the following most frequent post-covid neurological complications and consequences in mainly elderly and senile patients: cranial mononeuropathies, chemosensory dysfunction, encephalopathy, insomnia, stroke, acute meningoencephalitis, acute disseminated encephalomyelitis, acute polyneuropathy Guillain–Barré syndrome, and transverse myelitis. The benefits of vaccination against COVID-19 far outweigh the risks of possible post-vaccination neurological complications and consequences, especially in elderly and senile patients.

NLRP3 Inflammasome’s Activation in Acute and Chronic Brain Diseases—An Update on Pathogenetic Mechanisms and Therapeutic Perspectives with Respect to Other Inflammasomes

“…Based upon the above findings, Heneka et al [ 458 ] posited that NLRP3 inflammasome activation during COVID-19 heightens the risk for the later development of chronic neurodegenerative diseases. Independent clinical and epidemiological investigations indicated that SARS-CoV-2 infection and the ensuing “long COVID” tightly relate to the onset of AD, PD, prion disease (PrD), and other ailments, particularly in patients in advanced age or suffering from intercurrent illnesses (CVD, T2DM, hypertension, other neurological disorders) or severe/fatal COVID-19 [ 459 , 460 , 461 ]. Even more alarming, the receptor-binding domain of SARS-CoV-2’s S1 spike glycoprotein presents prion-like sequences.…”