Neurological manifestations and complications of COVID-19: A literature review

Imran Ahmad, Farooq Azam Rathore, Imran Ahmad, Farooq Azam Rathore

Abstract

The Coronavirus disease due to SARS-CoV-2 emerged in Wuhan city, China in December 2019 and rapidly spread to more than 200 countries as a global health pandemic. There are more than 3.5 million confirmed cases and around 165,000 to 243,000 fatalities. The primary manifestation is respiratory and cardiac but neurological features are also being reported in the literature as case reports and case series. The most common reported symptoms to include headache and dizziness followed by encephalopathy and delirium. Among the complications noted are Cerebrovascular accident, Guillian barre syndrome, acute transverse myelitis, and acute encephalitis. The most common peripheral manifestation was hyposmia. It is further noted that sometimes the neurological manifestations can precede the typical features like fever and cough and later on typical manifestations develop in these patients. Hence a high index of suspicion is required for timely diagnosis and isolation of cases to prevent the spread in neurology wards. We present a narrative review of the neurological manifestations and complications of COVID-19. Our aim is to update the neurologists and physicians working with suspected cases of COVID-19 about the possible neurological presentations and the probable neurological complications resulting from this novel virus infection.

Keywords: Clinical features; Coronavirus; Delirium; Encephalitis; Headache; Neurology; Stroke.

Copyright © 2020 Elsevier Ltd. All rights reserved.

References

    1. Zhu Na, Zhang Dingyu, Wang Wenling, Li Xingwang, Yang Bo, Song Jingdong, Zhao Xiang, Huang Baoying, Shi Weifeng, Lu Roujian, Niu Peihua, Zhan Faxian, Ma Xuejun, Wang Dayan, Xu Wenbo, Wu Guizhen, Gao George F., Tan Wenjie. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727–733. doi: 10.1056/NEJMoa2001017.
    1. Green A, Li Wenliang. Lancet Infect Dis. 2020. doi:10.1016/S0140-6736(20)30382-2
    1. World Health Organization. Pneumonia of unknown cause – China. Disease outbreak news. 5 January 2020 Available at (accessed 22nd April 2020).
    1. WHO Director-General's opening remarks at the media briefing on COVID-19 – 11 March 2020. 11 March 2020. Available at (accessed 22nd April 2020).
    1. World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report – 92 (accessed 22nd April 2020).
    1. World Health Organization. Global research on coronavirus disease (COVID-19) Available at (accessed 22nd April 2020).
    1. Memon A.R., Rathore F.A. Publishing research during pandemics: are you vulnerable to the COVID-19 or predatory publishers? J Pak Med Assoc. 2020;70(S1) In press.
    1. Di Gennaro F., Pizzol D., Marotta C., Antunes M., Racalbuto V., Veronese N., Smith L. Coronavirus diseases (COVID-19) current status and future perspectives: a narrative review. Int J Environ Res Public Health. 2020;17(8) doi: 10.3390/ijerph17082690. pii: E2690.
    1. Tu H., Tu S., Gao S., Shao A., Sheng J. The epidemiological and clinical features of COVID-19 and lessons from this global infectious public health event. J Infect. 2020 doi: 10.1016/j.jinf.2020.04.011. pii: S0163-4453(20)30222-X.
    1. Li Xiaowei, Geng Manman, Peng Yizhao, Meng Liesu, Lu Shemin. Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal. 2020;10(2):102–108. doi: 10.1016/j.jpha.2020.03.001.
    1. Mao L., Jin H., Wang M., Hu Y., Chen S., He Q., Chang J., Hong C., Zhou Y., Wang D., Miao X., Li Y., Hu B. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020 doi: 10.1001/jamaneurol.2020.1127.
    1. Helms J., Kremer S., Merdji H., Clere-Jehl R., Schenck M., Kummerlen C. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med. 2020 doi: 10.1056/NEJMc2008597.
    1. Lou J., Tian S.J., Niu S.M., Kang X.Q., Lian H.X., Zhang L.X. Coronavirus disease 2019: a bibliometric analysis and review. Eur Rev Med Pharmacol Sci. 2020;24(6):3411–3421.
    1. Wu Yeshun, Xu Xiaolin, Chen Zijun, Duan Jiahao, Hashimoto Kenji, Yang Ling, Liu Cunming, Yang Chun. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020 doi: 10.1016/j.bbi.2020.03.031.
    1. Li Yan‐Chao, Bai Wan‐Zhu, Hashikawa Tsutomu. The neuroinvasive potential of SARS‐CoV2 may play a role in the respiratory failure of COVID‐19 patients. J Med Virol. 2020;92(6):552–555. doi: 10.1002/jmv.v92.6.
    1. Baig A.M., Khaleeq A., Ali U., Syeda H. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci. 2020 Apr 1;11(7):995–998.
    1. Mehta P., McAuley D.F., Brown M., Sanchez E., Tattersall R.S., Manson J.J. HLH across speciality collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033–1034.
    1. Tveito K. Cytokine storms in COVID-19 cases? Tidsskr Nor Laegeforen. 2020 Mar;23:140. doi: 10.4045/tidsskr.20.0239.
    1. Filatov A., Sharma P., Hindi F. Neurological complications of coronavirus disease (COVID-19): encephalopathy. Cureus. 2020;12(3):e7352. doi: 10.7759/cureus.7352.
    1. Chen T., Wu D., Chen H., Yan W., Yang D., Chen G. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020;368:m1091. doi: 10.1136/bmj.m1091. Erratum in: BMJ. 2020 Mar 31;368:m1295.
    1. Poyiadji N., Shahin G., Noujaim D., Stone M., Patel S., Griffith B. COVID-19-associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features. Radiology. 2020:201187. doi: 10.1148/radiol.2020201187.
    1. Zhao K., Huang J., Dai D., Feng Y., Liu L., Nie S. Acute myelitis after SARS-CoV-2 infection: a case report. medRxiv. 2020
    1. Sharifi-Razavi A., Karimi N., Rouhani N. COVID 19 and intra cerebral hemorrhage: causative or coincidental. New Microbes New Infect. 2020 Mar;27
    1. Moriguchi Takeshi, Harii Norikazu, Goto Junko, Harada Daiki, Sugawara Hisanori, Takamino Junichi, Ueno Masateru, Sakata Hiroki, Kondo Kengo, Myose Natsuhiko, Nakao Atsuhito, Takeda Masayuki, Haro Hirotaka, Inoue Osamu, Suzuki-Inoue Katsue, Kubokawa Kayo, Ogihara Shinji, Sasaki Tomoyuki, Kinouchi Hiroyuki, Kojin Hiroyuki, Ito Masami, Onishi Hiroshi, Shimizu Tatsuya, Sasaki Yu, Enomoto Nobuyuki, Ishihara Hiroshi, Furuya Shiomi, Yamamoto Tomoko, Shimada Shinji. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int. J. Infectious Dis. 2020;94:55–58. doi: 10.1016/j.ijid.2020.03.062.
    1. Huang Chaolin, Wang Yeming, Li Xingwang, Ren Lili, Zhao Jianping, Hu Yi, Zhang Li, Fan Guohui, Xu Jiuyang, Gu Xiaoying, Cheng Zhenshun, Yu Ting, Xia Jiaan, Wei Yuan, Wu Wenjuan, Xie Xuelei, Yin Wen, Li Hui, Liu Min, Xiao Yan, Gao Hong, Guo Li, Xie Jungang, Wang Guangfa, Jiang Rongmeng, Gao Zhancheng, Jin Qi, Wang Jianwei, Cao Bin. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506. doi: 10.1016/S0140-6736(20)30183-5.
    1. Deng Yan, Liu Wei, Liu Kui, Fang Yuan-Yuan, Shang Jin, zhou Ling, Wang Ke, Leng Fan, Wei Shuang, Chen Lei, Liu Hui-Guo. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 (COVID-19) in Wuhan, China: a retrospective study. Chin Med J. 2020:1. doi: 10.1097/CM9.0000000000000824.
    1. Li Long‐quan, Huang Tian, Wang Yong‐qing, Wang Zheng‐ping, Liang Yuan, Huang Tao‐bi, Zhang Hui‐yun, Sun Weiming, Wang Yuping. COVID‐19 patients' clinical characteristics, discharge rate, and fatality rate of meta‐analysis. J Med Virol. 2020;92(6):577–583. doi: 10.1002/jmv.v92.6.
    1. Yan C.H., Faraji F., Prajapati D.P., Boone C.E., DeConde A.S. Association of chemosensory dysfunction and Covid-19 in patients presenting with influenza-like symptoms. Int Forum Allergy Rhinol. 2020 doi: 10.1002/alr.22579.
    1. Bagheri S.H., Asghari A.M., Farhadi M., Shamshiri A.R., Kabir A., Kamrava S.K. Coincidence of COVID-19 epidemic and olfactory dysfunction outbreak. medRxiv. 2020
    1. Zhao Hua, Shen Dingding, Zhou Haiyan, Liu Jun, Chen Sheng. Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol. 2020;19(5):383–384. doi: 10.1016/S1474-4422(20)30109-5.
    1. Sedaghat Zahra, Karimi Narges. Guillain Barre syndrome associated with COVID-19 infection: a case report. J. Clin. Neurosci. 2020 doi: 10.1016/j.jocn.2020.04.062.
    1. Virani Ahmed, Rabold Erica, Hanson Taylor, Haag Aaron, Elrufay Rawiya, Cheema Tariq, Balaan Marvin, Bhanot Nitin. Guillain-Barré Syndrome associated with SARS-CoV-2 infection. IDCases. 2020;20:e00771. doi: 10.1016/j.idcr.2020.e00771.
    1. Toscano G., Palmerini F., Ravaglia S., Ruiz L., Invernizzi P., Cuzzoni M.G., Franciotta D., Baldanti F., Daturi R., Postorino P., Cavallini A., Micieli G. Guillain-Barré Syndrome Associated with SARS-CoV-2. N Engl J Med. 2020 doi: 10.1056/NEJMc2009191.

Source: PubMed

Szponzorok és közreműködők

Egészségi állapot

Kábítószer-beavatkozások

3
Iratkozz fel