COVID-19 and the brain: neurological changes in COVID-19

Abstract

Coronavirus disease 19 (COVID-19) is a highly transmissible viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which emerged in Wuhan, China and has since spread rapidly around the world resulting in a global pandemic that has caused millions of deaths. Although primarily a disease of the respiratory tract, the spectrum of pathology in COVID-19 is wide and this has been linked to the ability of the virus to attack several organs of the human body such as the heart,  kidney and even the brain. A growing body of evidence shows that neuro-tropism is one common feature of coronaviruses.

Neurologic manifestations of COVID-19 are abundant and highly variable involving the central nervous system (dizziness, headache, impaired consciousness, ataxia, seizure and acute cerebrovascular disease), peripheral nervous system (smell impairment, vision impairment, (taste impairment, and nerve pain), and muscular-skeletal system. It can occur prior to its diagnosis or as a complication of the viral infection. The involvement of the nervous system can be due to its direct action on the nervous tissue or an indirect action through the activation of immune-mediated  mechanisms. Neurological complaints at any point during the course of the illness is associated with a higher risk of death.

This review elaborates on the neurological changes associated with the brain, potential mechanisms  of these changes and their clinical presentations.