Impact of SARS-CoV-2 on the nervous system

Neurol Neurochir Pol. 2023;57(1):26-35. doi: 10.5603/PJNNS.a2023.0009. Epub 2023 Feb 17.


Introduction: The ongoing COVID-19 pandemic is the largest global public health struggle. The spread of the novel coronavirus had resulted in almost 7 million deaths worldwide by January 2023.

State of the art: The most common symptoms during the acute phase of COVID-19 are respiratory. However, many individuals present various neurological deficits at different stages of the infection. Furthermore, there are post-infectious complications that can be present within weeks after the initial symptoms. Both the central and peripheral nervous systems (CNS and PNS, respectively) can be affected. Many potential mechanisms and hypotheses regarding the neuropathology behind COVID-19 have been proposed.

Clinical implications: The distribution of neurological symptoms during COVID-19 infection among studies differs greatly, which is mostly due to differing inclusion criteria. One of the most significant is incidence involving CNS circulation. In this review, we present basic information regarding the novel coronavirus, the possible routes along which the pathogen can reach the nervous system, neuropathology mechanisms, and neurological symptoms following COVID-19.

Future directions: It seems that many factors, resulting both from the properties of the virus and from systemic responses to infection, play a role in developing neurological symptoms. The long-term effect of the virus on the nervous system is still unknown.

Keywords: COVID-19; SARS-CoV-2; long-COVID; nervous system; stroke.

Publication types

  • Review

MeSH terms

  • COVID-19* / epidemiology
  • Humans
  • Nervous System Diseases* / epidemiology
  • Nervous System Diseases* / etiology
  • Pandemics
  • SARS-CoV-2