Neurological manifestations due to, during and after COVID-19

Patil A, Mohandas S

Pdf Page Numbers :- 81-89

Anuja Patil^1,* and Mohandas S¹

¹Department of Neurology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India

*Corresponding author: Dr. Anuja Patil, Consultant Neurology, Department of Neurology, Krishna Institute of Medical Sciences, Minister Road, Secunderabad-500003, Telangana, India. Email: patilanuja1986@gmail.com

Received 12 September 2020; Revised 22 October 2020; Accepted 13 November 2020; Published 19 November 2020

Citation: Patil A, Mohandas S. J Med Sci Res. 2020; 8(S1):81-89. DOI: http://dx.doi.org/10.17727/JMSR.2020/8S1-10

Copyright: © 2020 Patil A. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

With the ongoing pandemic of coronavirus disease 2019 (COVID-19), many neurological manifestations have been linked to what began as an outbreak of atypical pneumonia. Like other corona viruses, severe acute respiratory syndrome coronavirus (SARS-CoV-2) has potential for neurotropism. Viral invasion and likely pathogenecity has been associated with expression of ACE-2 receptors along endothelia and olfactory mucosa. Hyperinflammatory response after systemic infection is in part responsible for the severity and multi-organ dysfunction seen in severe cases. Features like encephalitis, central and peripheral demyelinating disorders, cranial neuropathies, stroke are seen not only in patients with severe illness but at times preceding any systemic symptoms. Neurological disorders are not only part of acute illness phase but also seen in postinfectious phase likely due to immune mediated effect. Also, long term sequelae in patients with moderate to severe COVID-19, either due to systemic complications or direct virus mediated effect are a matter of concern. High suspicion and early recognition of possible presenting features and neurological complications in severely affected patients is key for management. With the rapidity and enormity of ongoing pandemic whether these observations are causal or casual is yet to be determined. Further collaborations for comparisons of observations across the world in necessary to understand the potential impact of COVID-19. Accessing these observations will help in better understanding the agent host and environmental factors determining the expected impact of this pandemic. Reorganizing health care facilities to apt for better handling COVID-19 over time to come will help to mitigate the impact.

Keywords: COVID-19; neurological manifestations; encephalitis; stroke; neurotropism