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Published in: Journal of Neurology 9/2020

01-09-2020 | Coronavirus | Review

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

Author: Panagiotis Gklinos

Published in: Journal of Neurology | Issue 9/2020

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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.
Literature
1.
go back to reference Mahase E (2020) Covid-19: WHO declares pandemic because of “larming levels” of spread, severity, and inaction. BMJ 368:1036CrossRef Mahase E (2020) Covid-19: WHO declares pandemic because of “larming levels” of spread, severity, and inaction. BMJ 368:1036CrossRef
3.
go back to reference Ksiazek TG, Erdman D, Goldsmith CS, Zaki SR, Peret T, Emery S, Tong S, Urbani C, Comer JA, Lim W et al (2003) A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med 348:1953–1966CrossRefPubMed Ksiazek TG, Erdman D, Goldsmith CS, Zaki SR, Peret T, Emery S, Tong S, Urbani C, Comer JA, Lim W et al (2003) A novel coronavirus associated with severe acute respiratory syndrome. N Engl J Med 348:1953–1966CrossRefPubMed
4.
go back to reference Wu A, Peng Y, Huang B, Ding X, Wang X, Niu P et al (2020) Genome composition and divergence of the novel coronavirus (2019-nCoV) originating in China. Cell Host Microbe 27(3):325–328CrossRefPubMedPubMedCentral Wu A, Peng Y, Huang B, Ding X, Wang X, Niu P et al (2020) Genome composition and divergence of the novel coronavirus (2019-nCoV) originating in China. Cell Host Microbe 27(3):325–328CrossRefPubMedPubMedCentral
5.
go back to reference Cyranoski D (2020) Did pangolins spread the China coronavirus to people? Nature 2020. Cyranoski D (2020) Did pangolins spread the China coronavirus to people? Nature 2020.
6.
go back to reference Yong Z, Cao C, Shuangli Z et al (2020) Notes from the field: isolation of 2019-nCoV from a stool specimen of a Laboratory-confirmed case of the coronavirus disease 2019 (COVID-19). China CDC Weekly 2:123–124 Yong Z, Cao C, Shuangli Z et al (2020) Notes from the field: isolation of 2019-nCoV from a stool specimen of a Laboratory-confirmed case of the coronavirus disease 2019 (COVID-19). China CDC Weekly 2:123–124
7.
go back to reference Moriguchi T, Harii N, Goto J, Harada D, Sugawara H, Takamino J, Ueno M, Sakata H, Kondo K, Myose N, Nakao A, Takeda M, Haro H, Inoue O, Suzuki-Inoue K, Kubokawa K, Ogihara S, Sasaki T, Kinouchi H, Kojin H, Ito M, Onishi H, Shimizu T, Sasaki Y, Enomoto N, Ishihara H, Furuya S, Yamamoto T, Shimada S (2020) A first case of Meningitis/Encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. https://doi.org/10.1016/j.ijid.2020.03.062CrossRefPubMedPubMedCentral Moriguchi T, Harii N, Goto J, Harada D, Sugawara H, Takamino J, Ueno M, Sakata H, Kondo K, Myose N, Nakao A, Takeda M, Haro H, Inoue O, Suzuki-Inoue K, Kubokawa K, Ogihara S, Sasaki T, Kinouchi H, Kojin H, Ito M, Onishi H, Shimizu T, Sasaki Y, Enomoto N, Ishihara H, Furuya S, Yamamoto T, Shimada S (2020) A first case of Meningitis/Encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. https://​doi.​org/​10.​1016/​j.​ijid.​2020.​03.​062CrossRefPubMedPubMedCentral
8.
go back to reference Xiang P, Xu XM, Gao LL, Wang HZ, Xiong HF, Li RH et al (2020) First case of 2019 novel coronavirus disease with encephalitis. ChinaXiv 202003:00015 Xiang P, Xu XM, Gao LL, Wang HZ, Xiong HF, Li RH et al (2020) First case of 2019 novel coronavirus disease with encephalitis. ChinaXiv 202003:00015
10.
go back to reference Rossi A (2008) Imaging of acute disseminated encephalomyelitis. Neuroimaging Clin 18(1):149–161CrossRef Rossi A (2008) Imaging of acute disseminated encephalomyelitis. Neuroimaging Clin 18(1):149–161CrossRef
12.
go back to reference Li Y, Wang M, Zhou Y, Chang J, Xian Y, Mao L, Hong C, Chen S, Wang Y, Wang H, Li M, Jin H, Hu B (2020) Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study (3/3/2020). Doi: 10.2139/ssrn.3550025 Li Y, Wang M, Zhou Y, Chang J, Xian Y, Mao L, Hong C, Chen S, Wang Y, Wang H, Li M, Jin H, Hu B (2020) Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study (3/3/2020). Doi: 10.2139/ssrn.3550025
13.
go back to reference Mao L, Wang M, Chen S, He Q, Chang J, Hong C, Zhou Y, Wang D, Li Y, Jin H, Hu B (2020) Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. MedRxiv 2020.02.22.20026500. Doi: 10.1101/2020.02.22.20026500 Mao L, Wang M, Chen S, He Q, Chang J, Hong C, Zhou Y, Wang D, Li Y, Jin H, Hu B (2020) Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. MedRxiv 2020.02.22.20026500. Doi: 10.1101/2020.02.22.20026500
14.
go back to reference Suzuki M, Saito K, Min WP, Vladau C, Toida K, Itoh H, Murakami S (2007) Identification of viruses in patients with post- viral olfactory dysfunction. Laryngoscope 117(2):272–277CrossRefPubMedPubMedCentral Suzuki M, Saito K, Min WP, Vladau C, Toida K, Itoh H, Murakami S (2007) Identification of viruses in patients with post- viral olfactory dysfunction. Laryngoscope 117(2):272–277CrossRefPubMedPubMedCentral
16.
go back to reference Welge-Lussen A, Wolfensberger M (2006) Olfactory disorders following upper respiratory tract infections. Taste and smell, 63. Karger Publishers 2006:125–132 Welge-Lussen A, Wolfensberger M (2006) Olfactory disorders following upper respiratory tract infections. Taste and smell, 63. Karger Publishers 2006:125–132
18.
go back to reference Zhao H, Shen D, Zhou H, Liu J, Chen S (2020) Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol. pii: S1474-4422(20)30109-5. doi: 10.1016/S1474-4422(20)30109-5. Zhao H, Shen D, Zhou H, Liu J, Chen S (2020) Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol. pii: S1474-4422(20)30109-5. doi: 10.1016/S1474-4422(20)30109-5.
19.
go back to reference Metlay JP, Waterer GW, Long AC et al (2019) Diagnosis and treatment of adults with community-acquired pneumonia: an official clinical practice guideline of the American Thoracic Society and Infectious Disease Society of America. Am J Respir Crit Care Med 200:e45–e67CrossRefPubMedPubMedCentral Metlay JP, Waterer GW, Long AC et al (2019) Diagnosis and treatment of adults with community-acquired pneumonia: an official clinical practice guideline of the American Thoracic Society and Infectious Disease Society of America. Am J Respir Crit Care Med 200:e45–e67CrossRefPubMedPubMedCentral
20.
go back to reference Desforges M, Le Coupanec A, Dubeau P et al (2020) Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system? Viruses 12:14CrossRef Desforges M, Le Coupanec A, Dubeau P et al (2020) Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system? Viruses 12:14CrossRef
21.
go back to reference Desforges M, Le Coupanec A, Brison E et al (2014) Neuroinvasive and neurotropic human respiratory coronaviruses: potential neurovirulent agents in humans. Adv Exp Med Biol 807:75–96CrossRefPubMedPubMedCentral Desforges M, Le Coupanec A, Brison E et al (2014) Neuroinvasive and neurotropic human respiratory coronaviruses: potential neurovirulent agents in humans. Adv Exp Med Biol 807:75–96CrossRefPubMedPubMedCentral
22.
go back to reference Tsai LK, Hsieh ST, Chang YC (2005) Neurological manifestations in severe acute respiratory syndrome. Acta Neurol Taiwan 14(3):113–119PubMed Tsai LK, Hsieh ST, Chang YC (2005) Neurological manifestations in severe acute respiratory syndrome. Acta Neurol Taiwan 14(3):113–119PubMed
23.
go back to reference Hung EC, Chim SS, Chan PK et al (2003) Detection of SARS coronavirus RNA in the cerebrospinal fluid of a patient with severe acute respiratory syndrome. Clin Chem 49:2108–2109CrossRefPubMedPubMedCentral Hung EC, Chim SS, Chan PK et al (2003) Detection of SARS coronavirus RNA in the cerebrospinal fluid of a patient with severe acute respiratory syndrome. Clin Chem 49:2108–2109CrossRefPubMedPubMedCentral
25.
go back to reference Kim JE, Heo JH, Kim HO, Song SH, Park SS, Park TH et al (2017) Neurological complications during treatment of middle east respiratory syndrome. J Clin Neurol 13(3):227–233CrossRefPubMedPubMedCentral Kim JE, Heo JH, Kim HO, Song SH, Park SS, Park TH et al (2017) Neurological complications during treatment of middle east respiratory syndrome. J Clin Neurol 13(3):227–233CrossRefPubMedPubMedCentral
26.
go back to reference Berth SH, Leopold PL, Morfini GN (2009) Virus-induced neuronal dysfunction and degeneration. Front Biosci 14:5239–5259CrossRef Berth SH, Leopold PL, Morfini GN (2009) Virus-induced neuronal dysfunction and degeneration. Front Biosci 14:5239–5259CrossRef
30.
go back to reference Wang Y, Wang Y, Chen Y, Qin Q (2020) Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 92(6):568–576CrossRefPubMed Wang Y, Wang Y, Chen Y, Qin Q (2020) Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J Med Virol. 92(6):568–576CrossRefPubMed
31.
go back to reference Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ (2020) COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 395(10229):1033–1034CrossRefPubMedPubMedCentral Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ (2020) COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet 395(10229):1033–1034CrossRefPubMedPubMedCentral
Metadata
Title
Neurological manifestations of COVID-19: a review of what we know so far
Author
Panagiotis Gklinos
Publication date
01-09-2020
Publisher
Springer Berlin Heidelberg
Published in
Journal of Neurology / Issue 9/2020
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI
https://doi.org/10.1007/s00415-020-09939-5

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