Neurological manifestations of COVID-19: a review of what we know so far

Abstract

Coronavirus disease 2019 (COVID-19) has become a pandemic disease globally. While it mostly presents with respiratory symptoms, it has already been found that it could manifest with a series of neurological symptoms as well, either at presentation or during the course of the disease. Symptoms vary from non-specific such as headache or dizziness to more specific such as convulsions and cerebrovascular disease (CVD). This study aims to give an overview of the neurological manifestations of COVID-19 and discuss the potential pathogenetic mechanisms of central nervous system (CNS) involvement. Clinicians and especially internists, neurologists, and infectious disease specialists should be aware of these symptoms and able to recognize them early. Prompt diagnosis and immediate management of the neurological manifestations of the novel coronavirus will not only improve the prognosis of COVID-19 patients but will also prevent the dissemination of the disease due to misdiagnosed cases.

Retinal involvement and ocular findings in COVID‐19 pneumonia patients 

“…[35][36][37] Although two proven cases of positive CSF testing for SARS-CoV-2 have been described and one postmortem, there are no certain data proving that the virus is able to directly affect the central nervous system. 38,39 Our ndings, on a cohort of subjects in different stages of the disease, including ICU patients, seem to demonstrate that SARS-CoV-2 may not be able to cross ocular BRBs. Furthermore, to the best of our knowledge, we report the rst attempt to isolate SARS CoV-2 in human aqueous humour.…”

Retinal involvement and ocular findings in COVID-19 pneumonia patients

“…In the recent literature on COVID-19, there are only anecdotal reports of virus spread through the blood–brain barrier 35 – 37 . Although two proven cases of positive CSF testing for SARS-CoV-2 have been described and one post-mortem, there are no certain data proving that the virus is able to directly affect the central nervous system 38 , 39 . Our findings, on a cohort of subjects in different stages of the disease, including ICU patients, seem to demonstrate that SARS-CoV-2 may not be able to cross ocular BRBs.…”

Review of Burden, Clinical Definitions, and Management of COVID-19 Cases

“…75 Furthermore, there have been reported cases of COVID-19-associated stroke, encephalitis, acute transverse myelitis, perfusion abnormalities on CT, and Guillain-Barre syndrome. 74,[76][77][78][79][80][81] These included large-vessel strokes in five patients (younger than 50 years) in New York City, United States. 74 These observations raise concerns about possible neurological effects of the virus, the mechanisms of which are still a cause for speculation.…”