Neurological manifestations of SARS-CoV-2 - A systematic review

Abstract

Introduction. Following two coronaviral epidemics in 2002 and 2012, December 2019 saw the emergence of a potentially fatal coronavirus - SARS-CoV-2, which originated in Wuhan, China. While most coronaviruses are responsible for mild respiratory infections, they have been demonstrated to be neuroinvasive and neurotropic for over three decades. In this review, we assess whether SARS-CoV-2 follows this trend and if the neuroinvasive potential of this novel coronavirus is worthy of further investigation. Methods. To obtain sources for this study, we performed an online search through Pubmed, Researchgate and Google Scholar, finding 537 articles. After analysing them according to PRISMA, we included 14 in this review. Discussion. Data regarding neurological manifestations of SARS-CoV-2 is scarce and mostly inconsistent. There are however identifiable trends which might provide a basis for future research. There is strong evidence that this novel coronavirus may be neuroinvasive and could cause a wide array of neurological symptoms and complications. Cerebrospinal fluid testing may shed more light on the occurrence of SARS-CoV-2 in the central nervous system. Clarification of the respiratory failure mechanisms requires post mortem examinations and brain tissue analysis, and further research is of the utmost importance. However, we strongly believe that the existing evidence is enough to raise awareness among clinicians and help guide them through the diagnosis and optimal therapy of COVID-19 patients.