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Review
. 2024 Jul 24;16(8):1183.
doi: 10.3390/v16081183.

Neurological Complications of COVID-19: Unraveling the Pathophysiological Underpinnings and Therapeutic Implications

Affiliations
Review

Neurological Complications of COVID-19: Unraveling the Pathophysiological Underpinnings and Therapeutic Implications

Ashutosh Vashisht et al. Viruses. .

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease (COVID-19), induced a global pandemic with a diverse array of clinical manifestations. While the acute phase of the pandemic may be waning, the intricacies of COVID-19's impact on neurological health remain a crucial area of investigation. Early recognition of the spectrum of COVID-19 symptoms, ranging from mild fever and cough to life-threatening respiratory distress and multi-organ failure, underscored the significance of neurological complications, including anosmia, seizures, stroke, disorientation, encephalopathy, and paralysis. Notably, patients requiring intensive care unit (ICU) admission due to neurological challenges or due to them exhibiting neurological abnormalities in the ICU have shown increased mortality rates. COVID-19 can lead to a range of neurological complications such as anosmia, stroke, paralysis, cranial nerve deficits, encephalopathy, delirium, meningitis, seizures, etc., in affected patients. This review elucidates the burgeoning landscape of neurological sequelae associated with SARS-CoV-2 infection and explores the underlying neurobiological mechanisms driving these diverse manifestations. A meticulous examination of potential neuroinvasion routes by SARS-CoV-2 underscores the intricate interplay between the virus and the nervous system. Moreover, we dissect the diverse neurological manifestations emphasizing the necessity of a multifaceted approach to understanding the disease's neurological footprint. In addition to elucidating the pathophysiological underpinnings, this review surveys current therapeutic modalities and delineates prospective avenues for neuro-COVID research. By integrating epidemiological, clinical, and diagnostic parameters, we endeavor to foster a comprehensive analysis of the nexus between COVID-19 and neurological health, thereby laying the groundwork for targeted therapeutic interventions and long-term management strategies.

Keywords: COVID-19; NeuroCOVID; SARS-CoV-2; neurological complications; neurological manifestations.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Schematic representation of possible routes through which SARS-CoV-2 could invade the nervous system. (a) Blood–brain barrier: the virus may be able to breach this barrier and enter the brain, potentially causing inflammation and other neurological complications; (b) Retrograde axonal transport, which refers to the transport of the virus from peripheral nerves back to the brain. Once the virus enters the peripheral nervous system, it may be transported along nerve fibers back to the central nervous system.
Figure 1
Figure 1
Schematic representation of possible routes through which SARS-CoV-2 could invade the nervous system. (a) Blood–brain barrier: the virus may be able to breach this barrier and enter the brain, potentially causing inflammation and other neurological complications; (b) Retrograde axonal transport, which refers to the transport of the virus from peripheral nerves back to the brain. Once the virus enters the peripheral nervous system, it may be transported along nerve fibers back to the central nervous system.

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References

    1. Synowiec A., Szczepański A., Barreto-Duran E., Lie L.K., Pyrc K. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): A systemic infection. Clin. Microbiol. Rev. 2021;34:e00133-20. doi: 10.1128/CMR.00133-20. - DOI - PMC - PubMed
    1. Chakraborty C., Bhattacharya M., Sharma A.R. Present variants of concern and variants of interest of severe acute respiratory syndrome coronavirus 2: Their significant mutations in S-glycoprotein, infectivity, re-infectivity, immune escape and vaccines activity. Rev. Med. Virol. 2021;32:e2270. doi: 10.1002/rmv.2270. - DOI
    1. Scheepers C., Everatt J., Amoako D.G., Mnguni A., Ismail A., Mahlangu B., Wibmer C.K., Wilkinson E., Tegally H., San J.E., et al. The continuous evolution of SARS-CoV-2 in South Africa: A new lineage with rapid accumulation of mutations of concern and global detection. medRxiv. 2021 doi: 10.1101/2021.08.20.21262342. - DOI
    1. Mao L., Jin H., Wang M., Hu Y., Chen S., He Q., Chang J., Hong C., Zhou Y., Wang D., et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020;77:683–690. doi: 10.1001/jamaneurol.2020.1127. - DOI - PMC - PubMed
    1. Li Z., Liu T., Yang N., Han D., Mi X., Li Y., Liu K., Vuylsteke A., Xiang H., Guo X. Neurological manifestations of patients with COVID-19: Potential routes of SARS-CoV-2 neuroinvasion from the periphery to the brain. Front. Med. 2020;14:1–9. doi: 10.1007/s11684-020-0786-5. - DOI - PMC - PubMed

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