Neurological involvement in SARS-CoV-2 infection: A clinical systematic review
Objective: Reports of neurological involvement during Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection course are increasingly described. The aim of this review is to provide a clinical approach of SARS-CoV-2 neurological complications based on the direct or indirect (systemic/...
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| Format: | Article |
| Language: | English |
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Elsevier
2020-05-01
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| Series: | Brain, Behavior, & Immunity - Health |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666354620300594 |
| _version_ | 1818437188734418944 |
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| author | Pasquale Scoppettuolo Serena Borrelli Gilles Naeije |
| author_facet | Pasquale Scoppettuolo Serena Borrelli Gilles Naeije |
| author_sort | Pasquale Scoppettuolo |
| collection | DOAJ |
| description | Objective: Reports of neurological involvement during Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection course are increasingly described. The aim of this review is to provide a clinical approach of SARS-CoV-2 neurological complications based on the direct or indirect (systemic/immune-mediated) role of the SARS-CoV-2 in their genesis. Methods: A review of the current literature has been carried out up to May 20th 2020 according to the PRISMA guidelines. All case series and reports of adult neurological manifestations associated to SARS-CoV-2 published in English were considered. Review and fundamental research studies on Coronaviruses neuroinvasive potential were analyzed to support pathogenic hypothesis and possible underlying mechanisms. Clinical patterns were subdivided into three groups according to putative underlying mechanisms: direct invasion of central or peripheral nervous system, systemic disorders leading to acute CNS injuries and post-infectious neurological syndromes (PINS). Results: Sixteen case series and 26 case reports for a total of 903 patients were identified presenting with neurological involvement during SARS-CoV-2 infection. Hypo/anosmia and dys/ageusia were found in 826 patients and mainly attributed to direct viral invasion. Cerebrovascular complications occurred in 51 patients and related to viral infection associated systemic inflammation. PINS were described in only 26 patients. A wide heterogeneity of these reports emerged concerning the extension of the clinical examination and ancillary exams performed. Conclusions: Neurological complications of SARS-CoV-2 are mainly related to olfactory and gustatory sensory perception disorders through possible direct nervous system invasion while cerebrovascular disease and PINS are rare and due to distinct and indirect pathophysiological mechanisms. |
| first_indexed | 2024-12-14T17:20:42Z |
| format | Article |
| id | doaj.art-95c8cbc99be44488a02f9f1f3ba56351 |
| institution | Directory Open Access Journal |
| issn | 2666-3546 |
| language | English |
| last_indexed | 2024-12-14T17:20:42Z |
| publishDate | 2020-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brain, Behavior, & Immunity - Health |
| spelling | doaj.art-95c8cbc99be44488a02f9f1f3ba563512022-12-21T22:53:20ZengElsevierBrain, Behavior, & Immunity - Health2666-35462020-05-015100094Neurological involvement in SARS-CoV-2 infection: A clinical systematic reviewPasquale Scoppettuolo0Serena Borrelli1Gilles Naeije2Department of Neurology, Centre Hospitalier du Valais Romand, Sion, Switzerland; Corresponding author. Avenue du Champsec 80, 1951, Sion, Switzerland.Department of Neurology, CHU-Brugmann, Université Libre de Bruxelles, Brussels, BelgiumDepartment of Neurology, CHU-Hôpital Erasme, Université Libre de Bruxelles, Brussels, BelgiumObjective: Reports of neurological involvement during Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection course are increasingly described. The aim of this review is to provide a clinical approach of SARS-CoV-2 neurological complications based on the direct or indirect (systemic/immune-mediated) role of the SARS-CoV-2 in their genesis. Methods: A review of the current literature has been carried out up to May 20th 2020 according to the PRISMA guidelines. All case series and reports of adult neurological manifestations associated to SARS-CoV-2 published in English were considered. Review and fundamental research studies on Coronaviruses neuroinvasive potential were analyzed to support pathogenic hypothesis and possible underlying mechanisms. Clinical patterns were subdivided into three groups according to putative underlying mechanisms: direct invasion of central or peripheral nervous system, systemic disorders leading to acute CNS injuries and post-infectious neurological syndromes (PINS). Results: Sixteen case series and 26 case reports for a total of 903 patients were identified presenting with neurological involvement during SARS-CoV-2 infection. Hypo/anosmia and dys/ageusia were found in 826 patients and mainly attributed to direct viral invasion. Cerebrovascular complications occurred in 51 patients and related to viral infection associated systemic inflammation. PINS were described in only 26 patients. A wide heterogeneity of these reports emerged concerning the extension of the clinical examination and ancillary exams performed. Conclusions: Neurological complications of SARS-CoV-2 are mainly related to olfactory and gustatory sensory perception disorders through possible direct nervous system invasion while cerebrovascular disease and PINS are rare and due to distinct and indirect pathophysiological mechanisms.http://www.sciencedirect.com/science/article/pii/S2666354620300594SARS-CoV-2CoronavirusNeurological involvementNeuroinvasionReview |
| spellingShingle | Pasquale Scoppettuolo Serena Borrelli Gilles Naeije Neurological involvement in SARS-CoV-2 infection: A clinical systematic review Brain, Behavior, & Immunity - Health SARS-CoV-2 Coronavirus Neurological involvement Neuroinvasion Review |
| title | Neurological involvement in SARS-CoV-2 infection: A clinical systematic review |
| title_full | Neurological involvement in SARS-CoV-2 infection: A clinical systematic review |
| title_fullStr | Neurological involvement in SARS-CoV-2 infection: A clinical systematic review |
| title_full_unstemmed | Neurological involvement in SARS-CoV-2 infection: A clinical systematic review |
| title_short | Neurological involvement in SARS-CoV-2 infection: A clinical systematic review |
| title_sort | neurological involvement in sars cov 2 infection a clinical systematic review |
| topic | SARS-CoV-2 Coronavirus Neurological involvement Neuroinvasion Review |
| url | http://www.sciencedirect.com/science/article/pii/S2666354620300594 |
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