Highlights • COVID-19 can have CNS and PNS neurological manifestations. • Headache and hyposmia are common neurological symptoms. • COVID-19 could trigger cytokine storm. • COVID-19 neurological sequalae may be due to viral neuroinvasion and cytokine storm. • Cytokine storm-targeting therapies may help manage COVID-19 neurological symptoms. The new coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can trigger a hyperinflammatory state characterized by elevated cytokine levels known as hypercytokinemia or cytokine storm, observed most often in severe patients. Though COVID-19 is known to be a primarily respiratory disease, neurological complications affecting both the central and peripheral nervous systems have also been reported. This review discusses potential routes of SARS-CoV-2 neuroinvasion and pathogenesis, summarizes reported neurological sequelae of COVID-19, and examines how aberrant cytokine levels may precipitate these complications. Clarification of the pathogenic mechanisms of SARS-CoV-2 is needed to encourage prompt diagnosis and optimized care. In particular, identifying the presence of cytokine storm in patients with neurological COVID-19 manifestations will facilitate avenues for treatment. Future investigations into aberrant cytokine levels in COVID-19 patients with neurological symptoms as well as the efficacy of cytokine storm-targeting treatments will be critical in elucidating the pathogenic mechanisms and effective treatments of COVID-19.
【저자키워드】 COVID-19, Cytokine storm, coronavirus, hypercytokinemia, interferons, Guillain-Barré syndrome, Encephalopathy, Neurological complications, Cerebrovascular disease, skeletal muscle injury,