Neurological manifestations of COVID-19: A comprehensive literature review and discussion of mechanisms

Abstract

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SARS-CoV-2, Trait Anxiety, and the Microbiome

“…A recent review and critical discussion of SARS-CoV-2-associated neurological, cognitive and psychiatric deficits presents a multi-faceted profile of putative mechanisms underlying the neurotropic/neuroinvasive potential of the virus (32). Complementary in vivo, in vitro and neuropathological studies suggest convergent and potentially synergistic strategies used by SARS-CoV-2 for neuroinvasion, infection, and replication within CNS neurons and astrocytes with subsequent cellular and tissue damage linked to chronic neurological dysfunction (33)(34)(35).…”

“…Overall, the authors provided evidence for the neuroinvasive capacity of SARS-CoV-2 in an apparent ACE2-dependent mechanism. In contrast, the lack of consistency of recent in vitro and in vivo datasets supporting a direct neuroinvasion by SARS-CoV-2, suggests that a virus-induced loss of BBB integrity with heightened CNS influx of inflammatory molecules is the likely culprit in long COVID-associated neurological and psychiatric disorders ( 32 ). Accordingly, these long-term debilitating neurological sequelae appear to be functionally linked to chronic inflammatory conditions within CNS structures and potential key entry points, such as choroid plexa ( 18 ), via chronically activated microglia.…”

Neurological Manifestations and Outcomes in a Retrospective Cohort of Mexican Inpatients with SARS-CoV-2 Pneumonia: Design of a Risk Profile

“…Solid epidemiological data have shown that patients with COVID-19 present with frequent and diverse neurological symptoms regardless of the level of clinical severity [12][13][14], and these symptoms occurred more frequently in persons with more severe systemic presentations [15]. Currently, hospitalized patients represent a minority of COVID-19-infected cases, due to both the lack of risk factors for severe disease in many sectors of the general population and the introduction of the vaccine for SARS-CoV-2; however, non-hospitalized patients may also develop sequelae following infection, including neurological symptoms [15][16][17][18][19].…”

“…Neurological disturbances such as myopathy, disorientation/encephalopathy, neuropathy, stroke, seizures, cerebral hemorrhage, cerebral venous thrombosis, and subarachnoid hemorrhage are considered neurological complications of COVID-19 [14].…”

Occurrence of Guillain-Barre Syndrome During the Initial Symptomatic Phase of COVID-19 Disease: Coincidence or Consequence?

“…Infection by SARS-CoV-2 has been shown to lead to multiple neurological manifestations [ 3 ], with the most common being dizziness, headache, anosmia, and ageusia [ 4 ]. However, some isolated cases of GBS have also been reported worldwide [ 5 ].…”