Review of neurological manifestations in patients with COVID-19
Keywords:
Manifestaciones neurológicas, COVID-19, SARS-CoV-2, NeurotropismoAbstract
Background: COVID-19 is an emerging disease with global incidence, which exhibits numerous respiratory complications; however, neurological manifestations are reported in infected patients.
Objective: to argue the relationship between SARS-CoV-2 infection and neurological manifestations.
Methods: a bibliographic review was carried out during June 2020, for which 34 articles retrieved from databases such as The Lancet, Journal of Medical Virology, Neurology, among others, were consulted. Search strategies such as the combination of terms and Boolean operators were used, as well as theoretical methods of analysis-synthesis, induction-deduction and historical-logical.
Results: although respiratory symptoms predominate in the clinical picture of COVID-19, it is also possible to find numerous conditions in the nervous system of infected patients, which is possible thanks to the neurotropism, neurovirulence and neuroinvasion exhibited by the virus. The incidence and characteristics of the neurological manifestations of COVID-19 are not well established at present.Neurological patients are also susceptible to other diseases such as COVID-19, which can be misinterpreted in the current epidemiological situation.
Conclusions: neurological manifestations such as headaches, anosmia, cerebrovascular diseases, encephalitis, encephalopathy and Guillain-Barré syndrome have been observed in patients with COVID-9. The main aspects involved in the neurotropism, neurovirulence and neuroinvasion of SARS-CoV-2 are related to viral factors and host characteristics. The causes of the neurological manifestations of COVID-19 are not well established, therefore, a greater number of epidemiological studies are necessary.
DeCS: CORONAVIRUS INFECTIONS; NEUROLOGIC MANIFESTATIONS; RESPIRATORY TRACT DISEASES; REVIEW LITERATURE AS TOPIC; CORONAVIRUS.
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References
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https//www.medrxiv.org/content/medrxiv/early/2020/03/18/2020.03.16.20035105.full.pdf DOI: 10.1101/2020.03.16.20035105
30. Poyiadji N, Shahin G, Noujaim D, Stone M, Patel S, Griffith B. COVID-19-associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features. Radiology [Internet]. 2020 [citado 14 Jun 2020];296(2):E119-E120. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233386/. DOI: 10.1148/radiol.2020201187
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6. Arbour N, Day R, Newcombe J, Talbot PJ. Neuroinvasion by human respiratory coronaviruses. J Virol [Internet]. 2000 [citado 09 Jun 2020];74(19):8913-21. Disponible en: https://jvi.asm.org/content/74/19/8913.short
7. Carod-Artal FJ. Complicaciones neurológicas por coronavirus y COVID-19. Rev Neurol [Internet]. 2020 [citado 17 Jun 2020];70(9):311-322. Disponible en: https://www.neurologia.com/articulo/2020179 DOI:10.33588/rn.7009.2020179
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9. Li Yc, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol [Internet]. 2020 [citado 15 Jun 2020];92(6):552-5. Disponible en: https://onlinelibrary.wiley.com/doi/full/10.1002/jmv.25728
DOI: 10.1002/jmv.25728
10. Van-Doremalen N, Bushumaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med [Internet]. 2020 [citado 04 Jun 2020];382(16):1564-1567. Disponible en: https://www.nejm.org/doi/full/10.1056/nejmc2004973
DOI: 10.1056/nejmc2004873
11. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet [Internet]. 2020 [citado 10 Jun 2020];395(10223):497-506. Disponible en: https://www.sciencedirect.com/science/article/pii/S0140673620301835
DOI: 10.1016/S0140-6736(20)30183-5
12. Wei-Jie G, Zheng-Yi N, Yu H, Wen-Hua L, Chun-quan O, Jian-Xing H, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med [Internet]. 2020 [citado 13 Jun 2020];382(18):1708-1720. Disponible en: https://www.nejm.org/doi/full/10.1056/NEJMoa2002032
DOI: 10.1056/NEJMoa2002032
13. Fazzini E, Fleming J, Fahn S. Cerebrospinal fluid antibodies to coronavirus in patients with Parkinson´s disease. Mov Disord [Internet]. 1992 [citado 22 Jun 2020];7(2):153-8. Disponible en:
https://onlinelibrary.wiley.com/doi/abs/10.1002/mds.870070210 DOI: 10.1002/mds.870070210
14. Burks JS, Devald BL, Janovsky LD, Gerdes JC. Two coronavirus isolated from central nervous system tissue of two multiple sclerosis patients. Science [Internet]. 1980 [citado 22 Jun 2020];209(4459):933-4. Disponible en: https://science.sciencemag.org/content/209/4459/933.abstract
DOI: 10.1126/science.7403860
15. Salmi A, Ziola B, Hovi T, Reunanen M. Antibodies to coronaviruses OC43 and 229E in multiple sclerosis patients. Neurology [Internet]. 1982 [citado 21 Jun 2020];32(3):292-5. Disponible en: https://n.neurology.org/content/32/3/292.short
DOI: 10.1212/WNL.32.3.292
16. Dessau RB, Lisby G, Frederiksen JL. Coronaviruses in spinal fluid of ptients with acute monosymptomatic optic neuritis. Acta Neurol Scand [Internet]. 1999 [citado 20 Jun 2020];100(2):88-91. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0404.1999.tb01043.x
DOI: 10.1111/j.1600-0404.1999.tb01043.x
17. Martínez-Hernández E, Velasco-Fargas R. Mecanismos fisiopatogénicos de afectación neurológica. En: Ezpeleta D, García-Azorín D, editores. Manual COVID-19 para el neurólogo general [Internet]. San Sebastián de los Reyes, Madrid; España: Ediciones Sociedad Española de Neurología (SEN); 2020 [citado 20 Jun 220]. 62-76 p. Disponible en: https://www.pri.sld.cu/?p=5815
18. Turtle L. Respiratory failure alone does not suggest central nervous system invasion by SARS-CoV-2. J Med Virol [Internet]. 2020 [citado 21 Jun 2020];92(7): [aprox. 3p.]. Disponible en: https://onlinelibrary.wiley.com/doi/abs/10.1002/jmv.25828
DOI: 10.1002/jmv.25828
19. Mehta P, Mc Auley DF, Brown M, Sánchez E, Tattersall RS, Marson JJ, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet [Internet]. 2020 [citado 18 Jun 2020];395(10229):1033-4. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/pmc7270045/.
20. Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun [Internet]. 2020 [citado 19 Jun 2020];87(1):18-22. Disponible en: https://www.sciencedirect.com/science/article/pii/S0889159120303573
DOI: 10.1016/j.bbi.2020.03.031
21. Moreno-Zambrano D, Arévalo-Mora M, Freire-Bonifacini A, García-Santibanez R, Santibáñez-Vásquez R. Neurologic Manifestations Associated With SARS-CoV-2 Infection: A Neuro-Review of COVID-19. Rev Ecuat Neurol [Internet]. 2020 [citado 17 Jun 2020];29(1):115-24. Disponible en: http://revecuatneurol.com/magazin_issue_article/neurologic-manifestations-sarscov2-infection-neuro-review-covid-19-manifestaciones-neurologicas-infeccion-sarscov2-neuro-revision-covid-19/
22. Mao L, Wang M, Chen S, He Q, Chang J, Hong C, et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. JAMA [Internet]. 2020 [citado 11 Jun 2020];77(6):683-90. Disponible en: https://jamanetwork.com/journals/jamaneurology/article-abstract/2764549
DOI: 10.1101/2020.02.22.20026500
23. Li Y, Man L, Wang M, Zhou Y, Chang J, Xian Y, et al. Acute cerebrovascular disease following COVID-19: a single retrospective, observational study. Stroke Vasc Neurol [Internet]. 2020 [citado 20 Jun 2020]; 5(3): v279-284. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32616524/ DOI: 10.2139/ssrn.3550025
24. García-Moncó JC, Erro ME, García-Azorín D, Ezpeleta D. Cuadros clínicos neurológicos asociados a la infección por SARS-CoV-2. En: Ezpeleta D, García-Azorín D, editores. Manual COVID-19 para el neurólogo general [Internet]. San Sebastián de los Reyes, Madrid; España: Ediciones Sociedad Española de Neurología (SEN); 2020 [citado 20 Jun 220]. 62-76 p. Disponible en: https://www.pri.sld.cu/?p=5815
25. Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le-Bon SD, Rodríguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Oto-Rhino-Naryngol [Internet]. 2020 [citado 10 Jun 2020];1-11. Disponible en: http://link.springer.com/content/pdf/10.1007/s00405-020-05965-1.pdf
DOI: 10.1007/s00405-020-05965-1
26. Brann D, Tsukahara T, Weinreb C, Logan DW, Datta SR. Non-neural expression of SARS-CoV-2 entry genes in the olfactory epithelium suggests mechanisms underlying COVID-19- associated anosmi. Sci Adv [Internet]. 2020 [citado 23 Jun 2020];6(31):eabc5801. Disponible en: https://www.biorxiv.org/content/10.1101/2020.03.25.009084v3
DOI: 10.1101/2020.03.25.009084
27. Xiang P, Xu XM, Gao LL, Wang HZ, Xiong HF, Li RH, et al. First case of 2019 novel coronavirus disease with encephalitis. ChinaXiv [Internet]. 2020 [citado 16 Jun 2020];94:55-8. Disponible en: https://www.sciencedirect.com/science/article/pii/S1201971220301958
28. Moriguchi T, Harii N, Goto J, Harada D, Sugawara H, Takamino J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis [Internet]. 2020 [citado 20 Jun 2020];94:55-8. Disponible en: https://www-sciencedirect.com/science/article/pii/S1201971220301958
DOI: 10.1016/j.ijid.2020.03.062
29. Zhao K, Huang J, Dai D, Feng Y, Liu L, Nie S. Acute myelitis after SARS-CoV-2 infection: a case report. MedRxiv preprint [Internet]. 2020 [citado 14 Jun 2020];2(1):[aprox. 5 p.]. Disponible en:
https//www.medrxiv.org/content/medrxiv/early/2020/03/18/2020.03.16.20035105.full.pdf DOI: 10.1101/2020.03.16.20035105
30. Poyiadji N, Shahin G, Noujaim D, Stone M, Patel S, Griffith B. COVID-19-associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features. Radiology [Internet]. 2020 [citado 14 Jun 2020];296(2):E119-E120. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7233386/. DOI: 10.1148/radiol.2020201187
31. Zhao H, Shen D, Zhou H, Liu J, Chen S. Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol [Internet]. 2020 [citado 15 Jun 2020];19(5):383-4. Disponible en: https://www.thelancet.com/journals7laneur/article/PIIS1474-4422(20)30109-5/fulltext DOI: 10.1016/S1474-4422(20)30109-5
32. Sedaghat Z, Karimi N. Guillain Barré syndrome associated with COVID-19 infection: a case report. J Clin Neurosci [Internet]. 2020 [citado 22 Jun 2020];76:233-35. Disponible en: https://www.sciencedirect.com/science/article/pii/S0967586820308821 DOI: 10.1016/j.jocn.2020.04.062.
33. Gutiérrez-Otriz C, Méndez A, Rodrigo-Rey S, San Pedro-Murillo E, Bermejo-Guerrero R, Gordo-Mañas R, et al. Miller Fisher Syndrome and polyneuritis cranialis in COVID-19. Neurology [Internet]. 2020 [citado 22 Jun 2020];76:233-5. Disponible en: https://n.neurology.org/content/early/2020/04/17/WNL.0000000000009619.abstract
DOI: 10.1212/WNL.0000000000009619
34. Toscano G, Palmerini F, Ravaglia S, Ruiz L, Invernizzi P, Cuzzoni MG, et al. Guillain-Barre Syndrome Associated with SARS-CoV-2. N Engl J Med [Internet]. 2020 [citado 22 Jun 2020];382(26):[aprox. 3 p.]. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182017/pdf/NEJMc2009191.pdf
Published
2021-09-10
How to Cite
1.
López-Catá F de J, Matos-Santisteban MA, Castillo Miranda OL. Review of neurological manifestations in patients with COVID-19. Prog [Internet]. 2021 Sep. 10 [cited 2025 May 12];4(1):47-63. Available from: https://revprogaleno.sld.cu/index.php/progaleno/article/view/224
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Section
Artículos de Revisión
