Review Article
Central nervous system manifestations of COVID-19: A systematic review

https://doi.org/10.1016/j.jns.2020.116832Get rights and content

Highlights

  • Some patients with COVID-19 may show nonspecific neurological symptoms, such as confusion and headache.

  • A few patients with COVID-19 showed more specific neurological manifestations, such as seizure or cerebrovascular problems.

  • Neuroinvasion of SARS-CoV2 may partially explain why some patients develop respiratory failure.

Abstract

Objective

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.

Keywords

CNS
Coronavirus
COVID-19
Neurological
Seizure

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