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Review
. 2020 Apr;35(3):170-175.
doi: 10.1016/j.nrl.2020.03.001. Epub 2020 Apr 6.

Should we expect neurological symptoms in the SARS-CoV-2 epidemic?

[Article in English, Spanish]
J Matías-Guiu  1 , U Gomez-Pinedo  2 , P Montero-Escribano  2 , P Gomez-Iglesias  2 , J Porta-Etessam  2 , J A Matias-Guiu  2
Affiliations
Review

Should we expect neurological symptoms in the SARS-CoV-2 epidemic?

[Article in English, Spanish]
J Matías-Guiu et al. Neurologia (Engl Ed). 2020 Apr.

Abstract

Introduction: There is growing evidence that SARS-CoV-2 can gain access to the central nervous system (CNS). We revise the literature on coronavirus infection of the CNS associated with neurological diseases.

Development: Neurological symptoms were rarely reported in the SARS-CoV and MERS-CoV epidemics, although isolated cases were described. There are also reports of cases of neurological symptoms associated with CoV-OC43 and CoV-229E infection. The presence of neurological lesions, especially demyelinating lesions in the mouse hepatitis virus model, may explain the mechanisms by which coronaviruses enter the CNS, particularly those related with the immune response. This may explain the presence of coronavirus in patients with multiple sclerosis. We review the specific characteristics of SARS-CoV-2 and address the question of whether the high number of cases may be associated with greater CNS involvement.

Conclusion: Although neurological symptoms are not frequent in coronavirus epidemics, the high number of patients with SARS-CoV-2 infection may explain the presence of the virus in the CNS and increase the likelihood of early- or delayed-onset neurological symptoms. Follow-up of patients affected by the SARS-CoV-2 epidemic should include careful assessment of the CNS.

Keywords: Central nervous system; Coronavirus; Esclerosis múltiple; MERS-CoV; Mouse hepatitis virus; Multiple sclerosis; Neurological symptoms; SARS-CoV; SARS-CoV-2; Sistema nervioso central; Síntomas neurológicos; Virus murino de la hepatitis.

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