Potential neurological symptoms of COVID-19

Abstract

The coronavirus disease 2019 (COVID-19) outbreak in Wuhan, China has spread rapidly, with confirmed cases currently appearing in multiple countries. Although many details, such as the source of the virus and its ability to spread between individuals, remain unknown, an increasing number of cases have been confirmed to have been caused by human-to-human transmission. 1,2 The primary symptoms of COVID-19 include fever, dry cough, and fatigue. 2 However, some physicians in affected areas have found that some patients diagnosed with COVID-19 have not shown typical respiratory symptoms, such as fever and coughing, at the time of diagnosis; rather, some infected patients have exhibited only neurological symptoms as the initial symptoms, such as the following: (1) headache, languidness, unstable walking, and malaise, which may be due to non-specific manifestations caused by COVID-19 (the proportion of non-specific manifestations as the first symptoms needs to be further explored); (2) cerebral hemorrhage; (3) cerebral infarction; and (4) other neurological diseases. In a recent study of 214 patients with COVID-19, 78 (36.4%) patients had neurological manifestations, such as headache, dizziness, acute cerebrovascular diseases, and impaired consciousness. 3 Of these 214 patients, 40 (18.7%) patients required intensive care unit (ICU) interventions for their severe neurological involvement. 3 Currently, although there have been many cases of patients with COVID-19 complicated by cerebral hemorrhages, relevant studies on this association are lacking. Hence, the physiological relationship between COVID-19 and the incidence of cerebral hemorrhage remains unclear. Based on several lines of evidence, we hypothesize that COVID-19 may involve cranial hemorrhage. First, recent studies have shown that this novel severe acute respiratory syndrome (SARS) coronavirus, SARS-CoV-2, invades human respiratory

The need for neurologists in the care of COVID‐19 patients

“…The primary symptoms of COVID-19 include fever, dry cough and fatigue [2]. However, a recent report from Shandong, China, disclosed that a subset of patients did not suffer from respiratory symptoms but had neurological signs and symptoms [3]. Moreover, in a retrospective study from Wuhan, China, neurological symptoms were observed in 36.4% of the hospitalized patients with COVID-19 infection and pertained to both the central and peripheral nervous system [4].…”

“…This needs to be considered in addition to the potential risk of cardioembolic stroke due to ACE 2 expression in the heart and subsequent cardiac dysfunction [16]. Moreover, the number of reported cases of COVID-19 patients with intracerebral haemorrhage is increasing [3]. Whether this potential association is related to uncontrolled hypertension by interaction of SARS-CoV-2 with ACE 2 needs to be clarified.…”

Neurological Manifestations of Novel Coronavirus Disease in a 2-Month-Old Infant: A Case Report

“…4 Wang et al reported that 36.4% of adults with COVID-19 had neurological symptoms, including headache, dizziness, weakness, cerebral hemorrhage, and infarction. 5 This study indicated that despite the high good growth. She was being breastfed.…”

“…5,6 In some adult studies, central nervous system (CNS) symptoms such as dizziness, weakness, lethargy, and unstable gait were reported. 5 In some cases, even cerebral hemorrhage was evident. 5 Although research in this area is very limited, there is a theory that postulates that a cerebral hemorrhage could follow a COVID-19 infection.…”

“…5 In some cases, even cerebral hemorrhage was evident. 5 Although research in this area is very limited, there is a theory that postulates that a cerebral hemorrhage could follow a COVID-19 infection. 5 In searching the literature, we did not find any COVID-19-related neurological manifestations in children.…”