Neurological Involvement in COVID-19 Patients: A Narrative Review

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) belonging to the coronavirus family. The primary target of SARS-CoV-2 is peripheral mucosal cells of respiratory tract. Recent days have seen few cases where virus has affected extrapulmonary organ such as nervous system. Materials and Methods: The present study was a narrative review done using techniques of systemic review, that is, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases such as PubMed (Medline) and Google Scholar were searched systematically for published article from December 1, 2019 to June 5, 2020. A total of 189 articles were initially selected by the authors. A final list of 17 articles was prepared and following information were extracted from selected studies: study design, main result, and limitations of the study. Results: Majority of these article were descriptive studies describing spectrum of signs and symptoms among admitted patients. In majority of these studies, patients have developed symptoms suggestive of neurological involvement. Most common central nervous system symptoms reported were headache, followed by dizziness and confusion. Similarly, the most common peripheral nervous system involvement was loss of taste and smell. Conclusion: The present study concludes that there are enough evidences to prove that SARS-CoV-2 infection affects both central and peripheral nervous system. Various mechanisms are proposed to explain the pathophysiology of neurological manifestations in COVID-19-positive patients that needs to be established and verified.