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Journal of the Neurological Sciences
journal homepage:www.elsevier.com/locate/jns
Review Article
Central nervous system manifestations of COVID-19: A systematic review
Ali A. Asadi-Pooyaa,b ,⁎, Leila SimanicaEpilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, IranbJefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, USAcSkull Base Research Center, Loghman Hakim Hospital, Shahid Beheshti Univsersity of Medical Sciences, Tehran, IranARTICLE INFOKeywords:CNSCoronavirusCOVID-19NeurologicalSeizure
ABSTRACTObjective:In this systematic review, we will discuss the evidence on the occurrence of central nervous system(CNS) involvement and neurological manifestations in patients with COVID-19.
Methods: MEDLINE (accessed from PubMed) and Scopus from December 01, 2019 to March 26, 2020 were systematically searched for related published articles. In both electronic databases, the following search strategy was implemented and these key words (in the title/abstract) were used:
“COVID 19” OR “coronavirus” AND “brain” OR“ CNS” OR “neurologic”.
Results:Through the search strategy, we could identify two articles about neurological involvement by COVID-19. One of these publications was a narrative review and the other one was a viewpoint. However, the authors scanned the reference lists of the included studies and could identify multiple references. One study, specifically investigated the neurological manifestations of COVID-19 and could document CNS manifestations in 25% of the patients. Most of the studies investigated the manifestations of COVID-19 in general.
Conclusion:While neurological manifestations of COVID-19 have not been studied appropriately, it is highly likely that some of these patients, particularly those who suffer from a severe illness, have CNS involvement and neurological manifestations. Precise and targeted documentation of neurological symptoms, detailed clinical, neurological, and electrophysiological investigations of the patients, attempts to isolate SARS-CoV-2 from cerebrospinal fluid, and autopsies of the COVID-19 victims may clarify the role played by this virus in causing neurological manifestations
Introduction:
Coronavirus is one of the major viruses that primarily targets the human respiratory system, but it also has neuroinvasive capabilities and can spread from the respiratory tract to the central nervous system (CNS). Previous epidemics or pandemics of coronaviruses include the severe acute respiratory syndrome (SARS) in 2002 and the Middle East respiratory syndrome (MERS) in 2012. The most recent pandemic of coronavirus infection is coronavirus disease (COVID-19) that is caused by SARS-CoV2 [1, 2]. The symptoms of COVID-19 infection usually appear after an incubation period of about five days.
The most common symptoms of COVID-19 illness are
- fever,
- cough, and
- fatigue;
- headache,
- hemoptysis, and
- dyspnea, among others.
- pneumonia,
- acute respiratory distress syndrome (ARDS),
- acute cardiac problems, and
- multi organ failure (MOF) [1].
The first cases of COVID-19 were reported in December2019 [1]; however, when we searched the MEDLINE (accessed from PubMed), from December 01, 2019 to March 26, 2020, with the keyword “COVID 19”, surprisingly 1655 articles were yielded. This shows that COVID-19 pandemic is of great global public health concern. Coronavirus infections have been associated with neurological manifestations (e.g.,
- febrile seizures,
- convulsions,
- change in mentalstatus, and
- encephalitis) [2, 3].
- (CNS) inflammation and
- demyelination [3].
- CNS involvement and
- neurological manifestations
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