Neurological manifestations of COVID-19: A comprehensive literature review and discussion of mechanisms

J Neuroimmunol. 2021 Sep 15:358:577658. doi: 10.1016/j.jneuroim.2021.577658. Epub 2021 Jul 10.

Abstract

Several neurological symptoms and complications have been described in association with COVID-19, such as anosmia, ageusia, encephalitis and Guillain-Barré syndrome. Here, we review the literature describing SARS-CoV-2-induced neurological manifestations and provide a comprehensive discussion of proposed mechanisms underlying the neurological pathophysiology. First, we analyse the neuroinvasiveness potential of the coronavirus family based on previous SARS-CoV-1 studies. Then, we describe the current evidence on COVID-19-induced nervous tissue damage, including processes behind brain vasculopathy and cytokine storm. We also discuss in detail anosmia and Guillain-Barré syndrome. Finally, we provide a summarised timeline of the main findings in the field. Future perspectives are presented, and suggestions of further investigations to clarify how SARS-COV-2 can affect the CNS.

Keywords: Anosmia; COVID-19; Cytokine storm; Encephalitis; Guillain-Barré syndrome.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Brain / immunology*
  • Brain / pathology
  • COVID-19 / complications*
  • COVID-19 / diagnosis
  • COVID-19 / immunology*
  • Humans
  • Nervous System Diseases / diagnosis
  • Nervous System Diseases / etiology*
  • Nervous System Diseases / immunology*
  • SARS-CoV-2 / immunology*