COVID-19: dealing with a potential risk factor for chronic neurological disorders

J Neurol. 2021 Apr;268(4):1171-1178. doi: 10.1007/s00415-020-10131-y. Epub 2020 Aug 27.

Abstract

SARS-CoV2 infection is responsible for a complex clinical syndrome, named Coronavirus Disease 2019 (COVID-19), whose main consequences are severe pneumonia and acute respiratory distress syndrome. Occurrence of acute and subacute neurological manifestations (encephalitis, stroke, headache, seizures, Guillain-Barrè syndrome) is increasingly reported in patients with COVID-19. Moreover, SARS-CoV2 immunopathology and tissue colonization in the gut and the central nervous system, and the systemic inflammatory response during COVID-19 may potentially trigger chronic autoimmune and neurodegenerative disorders. Specifically, Parkinson's disease, multiple sclerosis and narcolepsy present several pathogenic mechanisms that can be hypothetically initiated by SARS-CoV2 infection in susceptible individuals. In this short narrative review, we summarize the clinical evidence supporting the rationale for investigating SARS-CoV2 infection as risk factor for these neurological disorders, and suggest the opportunity to perform in the future SARS-CoV2 serology when diagnosing these disorders.

Keywords: COVID-19; Demyelination; Multiple sclerosis; Narcolepsy; Neurodegeneration; Neuroinflammation; Parkinson’s disease; Risk factors; SARS-CoV2; Sleepiness.

Publication types

  • Review

MeSH terms

  • COVID-19 / complications*
  • Chronic Disease
  • Humans
  • Nervous System Diseases / virology*
  • Risk Factors
  • SARS-CoV-2