The underrated nervous system involvement by COVID-19

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly pathogenic virus that causes severe pneumonia and acute respiratory distress syndrome. On March 11, 2020, this novel coronavirus was declared a pandemic by the World Health Organization. To date, millions of patients have been infected. Recent reports indicate that a substantial proportion of cases present with neurological symptoms. However, it remains to be elucidated whether these manifestations are secondary to direct nervous system invasion, indirect damage mediated by a systemic inflammatory response, or a combination of both. In this review, we explore the potential routes for central nervous system involvement, the possible pathogenic mechanisms in the nervous system and the conceivable neurological long-term sequoia of infection by SARS-CoV-2 infection. Future efforts should concentrate on clarifying the pathophysiology of the neurological component of COVID-19.