COVID-19 and its effects on neurological functions

Trop Biomed. 2021 Sep 1;38(3):435-445. doi: 10.47665/tb.38.3.086.

Abstract

Ever since the first reported case series on SARS-CoV-2-induced neurological manifestation in Wuhan, China in April 2020, various studies reporting similar as well as diverse symptoms of COVID-19 infection relating to the nervous system were published. Since then, scientists started to uncover the mechanism as well as pathophysiological impacts it has on the current understanding of the disease. SARS-CoV-2 binds to the ACE2 receptor which is present in certain parts of the body which are responsible for regulating blood pressure and inflammation in a healthy system. Presence of the receptor in the nasal and oral cavity, brain, and blood allows entry of the virus into the body and cause neurological complications. The peripheral and central nervous system could also be invaded directly in the neurogenic or hematogenous pathways, or indirectly through overstimulation of the immune system by cytokines which may lead to autoimmune diseases. Other neurological implications such as hypoxia, anosmia, dysgeusia, meningitis, encephalitis, and seizures are important symptoms presented clinically in COVID-19 patients with or without the common symptoms of the disease. Further, patients with higher severity of the SARS-CoV-2 infection are also at risk of retaining some neurological complications in the long-run. Treatment of such severe hyperinflammatory conditions will also be discussed, as well as the risks they may pose to the progression of the disease. For this review, articles pertaining information on the neurological manifestation of SARS-CoV-2 infection were gathered from PubMed and Google Scholar using the search keywords "SARS-CoV-2", "COVID-19", and "neurological dysfunction". The findings of the search were filtered, and relevant information were included.

Publication types

  • Review

MeSH terms

  • Angiotensin-Converting Enzyme 2 / metabolism
  • Anosmia / virology
  • COVID-19 / pathology*
  • Central Nervous System / pathology*
  • Central Nervous System / virology
  • Dysgeusia / virology
  • Encephalitis, Viral / virology
  • Humans
  • Meningitis, Viral / virology
  • Nervous System Diseases / pathology
  • Nervous System Diseases / virology*
  • Peripheral Nervous System / pathology*
  • Peripheral Nervous System / virology
  • SARS-CoV-2
  • Seizures / virology

Substances

  • ACE2 protein, human
  • Angiotensin-Converting Enzyme 2