COVID-19: A brain virus? COVID-19 and neurological manifestations: a systematic review

BackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for Corona Virus Disease-19 (COVID-19), initially identified in Wuhan, China, has been primarily recognized as a respiratory pathogen. However, evidence has emerged suggesting its impact on various organ systems, including the central nervous system. This systematic review aims to comprehensively investigate and analyze the neurological manifestations of COVID-19, shedding light on its potential as a brain-invading virus.MethodsA systematic literature search was conducted across multiple databases, including Google Scholar, PubMed, Cureus, and the World Health Organization's database. Studies employing case-control methods, population-based cohort studies, or human clinical trials were prioritized for data extraction. The Joanna Briggs Institute tool was employed for quality assessment.ResultsNeurological manifestations in COVID-19 patients vary widely, ranging from headache, dizziness, and myalgias to severe complications such as stroke, seizures, and encephalopathy. Encephalopathy emerged as a common complication, affecting up to 40% of patients. Stroke incidence ranged from 1 to 6%, and seizures were reported in 0.6% to 13.5% of cases. Peripheral nerve disorders and Guillain-Barr & eacute; Syndrome were also documented. Mechanisms of neurological injury include direct viral invasion, immune-mediated inflammation, and hypoxia.ConclusionsCOVID-19 exhibits a range of neurological manifestations beyond its respiratory impact. Encephalopathy, stroke, seizures, and peripheral nerve disorders are among the severe complications reported. The mechanisms underlying these neurological effects remain complex and multifaceted. Recognition of these manifestations is crucial for timely and appropriate management.