Increasing evidence suggests that Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) can also invade the central nervous system (CNS). However, findings available on its neurological manifestations and their pathogenic mechanisms have not yet been systematically addressed. A literature search on neurological complications reported in patients with COVID-19 until June 2020 produced a total of 23 studies. Overall, these papers report that patients may exhibit a wide range of neurological manifestations, including encephalopathy, encephalitis, seizures, cerebrovascular events, acute polyneuropathy, headache, hypogeusia, and hyposmia, as well as some non-specific symptoms. Whether these features can be an indirect and unspecific consequence of the pulmonary disease or a generalized inflammatory state on the CNS remains to be determined; also, they may rather reflect direct SARS-CoV-2-related neuronal damage. Hematogenous versus transsynaptic propagation, the role of the angiotensin II converting enzyme receptor-2, the spread across the blood-brain barrier, the impact of the hyperimmune response (the so-called “cytokine storm”), and the possibility of virus persistence within some CNS resident cells are still debated. The different levels and severity of neurotropism and neurovirulence in patients with COVID-19 might be explained by a combination of viral and host factors and by their interaction.
【저자키워드】 COVID-19, coronavirus, immune response, neuroinvasion, cerebrospinal fluid, neurotropism, Brain imaging, molecular mechanisms, neurovirulence, 【초록키워드】 SARS-CoV-2, severity, headache, virus, Symptoms, Encephalitis, Spread, persistence, Patient, neurological manifestations, Encephalopathy, Central nervous system, respiratory, CNS, pathogenic mechanism, non-specific, pulmonary disease, Hyposmia, Evidence, Combination, Interaction, inflammatory state, Neurological complication, Seizures, Hypogeusia, Factor, enzyme, Host, neurological manifestation, feature, Cell, produced, reported, events, explained, addressed, Increasing, “cytokine storm”, hyperimmune response, neuronal, patients with COVID-19, 【제목키워드】 SARS-CoV-2, clinical, nervous,