Neurological manifestations in patients with COVID-19
Keywords:
COVID-19, SARS-CoV-2, Nervous System DiseasesAbstract
Introduction: COVID-19 pandemic represents a challenge for healthcare systems, due to the impact on different systems, such as respiratory, cardiovascular and nervous systems.
Objective: to describe the neurological manifestations in patients with COVID-19.
Methods: a search for information was carried out in the PubMed/Medline, SciELO, EBSCO, Lilacs and Scopus databases. A search strategy was applied by combining terms and using Boolean operators. Thirty references were chosen.
Results: olfactory nerves and invasion of peripheral nerve terminals are suggested as routes of entry; the presence of severe neural symptoms associated with lesions of other organs and cytokine storm is also described. Headache was the most common neurological manifestation in patients with COVID-19, and rhabdomyolysis, acute hemorrhagic necrotizing encephalopathy, Guillain Barré syndrome, meningitis and encephalitis are rare neurological entities. In Guillain Barré syndrome, the literature suggests both a post infectious and para-infectious pattern.
Conclusions: COVID-19 is associated with different neurological manifestations, including headache, dizziness, vertigo, vomiting, and alterations of consciousness, stroke and others not so frequent. These symptoms as a whole should be evaluated by healthcare personnel, with a view to their rapid detection and management, in order to guarantee the disappearance of sequelae that reduce the quality of life of patients, as well as to reduce the associated mortality records.
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References
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30. Barrachina Esteve O. Domínguez Palau A. Hidalgo Torrico I. Viguera Martinez ML. Síndrome de Guillain-Barré como forma de presentación de la infección por SARS-CoV-2. Rev Neurol. [Internet]. 2020 [citado 08/02/2021]; 3(9): 710-712. Disponible en: https://www.elsevier.es/es-revista-neurologia-295-articulo-sindrome-guillain-barre-como-forma-presentacion-S0213485320302085
2. Giralt-Herrera A, Rojas-Velázquez JM, Leiva-Enríquez J. Relación entre COVID-19 e Hipertensión Arterial. Rev haban cienc méd [Internet]. 2020 [citado 08/02/2021]; 19(2):e3246. Disponible en: http://www.revhabanera.sld.cu/index.php/rhab/article/view/3246
3. Moreno-Zambrano D, Arévalo-Mora M, Freire-Bonifacini A, García-Santibanez R, Santibañez-Vásquez R, Manifestaciones Neurológicas Asociadas a la Infección Por SARS-CoV-2: Una Neuro-Revisión de COVID-19, Rev. Ecuat. Neurol. [Internet] 2020. [citado 08/02/2021]; 29(1): 1-10. Disponible en: http://revecuatneurol.com/wp-content/uploads/2020/05/2631-2581-rneuro-29-01-00115.pdf
4. Pérez Abreu MR, Gómez Tejeda JJ, Dieguez Guach RA. Características clínico-epidemiológicas de la COVID-19. Rev haban cienc méd [Internet]. 2020 [citado 08/02/2021]; 19(2):e3254. Disponible en: http://www.revhabanera.sld.cu/index.php/rhab/article/view/3254/2505
5. Candelaria-Brito JC, Díaz-Cruz SA, Acosta-Pérez DM, Labrador-Mazón O, Rodríguez-Méndez A. Estrategia intervencionista dirigida a la prevención y control de la COVID-19 en Consolación del Sur. Rev Ciencias Médicas [Internet]. 2020 [citado 08/02/2021]; 24(3):e4495. Disponible en: http://revcmpinar.sld.cu/index.php/publicaciones/article/view/4495
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7. Gómez-Tejeda JJ, Dieguez-Guach RA, Pérez-Abreu MR. Alternativas terapéuticas para el manejo de la COVID-19. Rev haban cienc méd [Internet]. 2020 [citado 08/02/2021]; 19(Supl.): e3328. Disponible en: http://www.revhabanera.sld.cu/index.php/rhab/article/view/3328
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9. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet [Internet]. 2020 [citado 08/02/2021]; 395(10223):497-506. Disponible en: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30183-5/fulltext?
10. Cheng VC, Lau SK, Woo PC, Yuen KY. Severe acute respiratory syndrome coronavirus as an agent of emerging and reemerging infection. Clin Microbiol Rev. [Internet]. 2007 [citado 08/02/2021]; 20(4):660–694. Disponible en: http://www.doi:10.1128/CMR.00023-07
11. Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. [Internet]. 2020 [citado 08/02/2021]; 77(6): 683-690. Disponible en: https://jamanetwork.com/journalsjamaneurology/fullarticle/2764549
12. Rodriguez Morales AJ, Cardona Ospina JA, Gutiérrez Ocampo E, Vallamizar Peña R, Holguín Rivera T,Escalera Antenazana JA, y col. Clinical, laboratory and imaging features of COVID-19: A systematic review and metaanalysis. Travel Med Infect Dis. [Internet]. 2020 [citado 08/02/2021]; Disponible en: http://www.doi:10.1016/j. tmaid.2020.101623
13. Aldámiz-Echevarría Lois MT, Aledo Serrano A, Hernández González-Monje M, Catalán Alfonso P, Díez Romero C, Martínez Hernández E, et al. Manual COVID-19 para el neurólogo general. Madrid: Ediciones SEN; 2020
14. Schwartz DA. Maternal Coronavirus Infections and Pregnancy Outcomes. Arch Pathol Lab Med [Internet]. 2020 [citado 08/02/2021]; 144:799-805. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32180426/
15. Manji H, S Carr A, Brownlee WJ, Lunn MP, Neurology in the time of COVID-19, J Neurol Neurosurg Psychiatry [Internet]. 2020. [citado 08/02/2021]. 91(6); 10-11 . Disponible en: https://jnnp.bmj.com/content/jnnp/91/6/568.full.pdf
16. Poyiadji N, Shahin G, Noujaim D, Stone M, Patel, Griffith B. COVID-19—asociated acute hemorragic necrotizing encephalopathy: CT and MRI features. Radiology [Internet]. 2020 [citado 08/02/2021]; 83(2): 127-133. Disponible en: https://doi.org/10.20453/rnp.v83i2.3756
17. Ashutosh K, Vikas P, Pranav P, Muneeb AF, Pavan K, Chiman K, et al. Posibles rutas de invasión en el cerebro del SARS-CoV-2: en el contexto de síntomas neurológicos en pacientes con covid-19. Rev de investigaciones neurocientíficas. [Internet]. 2020 [citado 08/02/2021]; 98: 2376-2383. Disponible en: https://publons.com/publon/10.1002/jnr.24717
18. Xu XW, Wu X-X, Jiang X-G, Xu H-J, Ying L-J, Ma C-L, y col. Clinical fidings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. [Internet]. 2020 [citado 08/02/2021]; 19: 368. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32075786
19. Zhang P. Invited Commentary: Be cautious of comorbidities of COVID-19 and neurologic diseases. Neurol Blogs. [Internet]. 2020 [citado 08/02/2021] Disponible en: https://blogs.neurology.org/global/invited-commentarybe-cautious-of-comorbidities-of-covid-19-and-neurologicdiseases/
20. Guan WJ, Ni ZY, Hu Y, Liang WH, Ph D, Yu Hu MD, y col. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. [Internet]. 2020. [citado 08/02/2021]; 382: 1708-1720. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32109013
21. Li Y, Wang M, Zhou Y, Chang J, Xian Y, Mao L, y col. Acute Cerebrovascular Disease Following COVID-19: A Single Center, Retrospective, Observational Study. [Internet]. 2020. [citado 08/02/2021]: 5(3): 279-284. Disponible en: http://dx.doi.org/10.2139/ssrn.3550025
22. Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol [Internet]. 2020 [citado 08/02/2021]; 92(6): 552-555. Disponible en: https://doi.org/10.1002/jmv.25728
23. Jin M, Tong Q. Rhabdomyolysis as potential late complication associated with COVID-19. Emerg Infect Dis. [Internet] 2020. [citado 08/02/2021]; 26(7): 1618-1620. Disponible en: https://doi.org/10.3201/eid2607.200445
24. Zhao H, Shen D, Zhou H, Liu J, Chen S. Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol. [Internet]. 2020 [citado 08/02/2021]; 19(5): 383-4. Disponible en: https://doi.org/10.1016/S1474-4422(20)30109-5
25. Moriguchi T, Harii N, Goto J,Harada D, Sugwara H, Takamino J, y col. A fisrt Case of Meningitis/ Encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis [Internet]. 2020 [citado 08/02/2021]; 94: 55-58. Disponible en: https://reader.elsevier.com/reader/sd/pii/S1201971220301958?token=BB69B2C364405430A881A7A1C5FEC519E413F7DE413598E3A971A36C6B605B7F842EA12752A961A307C0DF6EF70178AE&originRegion=us-east-1&originCreation=20211018194935
26. Helms J, Kremer S, Merdji H, Clere-Jehl R, Schenck M, Kummerlen C, y col. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med [Internet]. 2020 [citado 08/02/2021]; 382(23): 2268-2270. Disponible en: https://www.nejm.org/doi/full/10.1056/NEJMc2008597
27. Filatov A, Sharma P, Hindi F, Esponosa PS. Neurological complications of coronavirus (COVID-19): encephalopathy. Cureus. [Internet]. 2020 [citado 08/02/2021]; 12(3): e7352. Disponible en: https://doi.org/10.7759/cereus.7352
28. Lechien JR, Chisea-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European Study. Eur Arch Otorhinolaryngol [Internet]. 2020 [citado 08/02/2021]; 277(8):2251-2261. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32253535/
29. Sedaghat Z, Karimi N. Guillain Barre syndrome associated with COVID-19 infection: a case report. J Clin Neurosci. [Internet]. 2020 [citado 08/02/2021]. 76: 233–235. Disponible en: https://pubmed.ncbi.nlm.nih.gov/32312628
30. Barrachina Esteve O. Domínguez Palau A. Hidalgo Torrico I. Viguera Martinez ML. Síndrome de Guillain-Barré como forma de presentación de la infección por SARS-CoV-2. Rev Neurol. [Internet]. 2020 [citado 08/02/2021]; 3(9): 710-712. Disponible en: https://www.elsevier.es/es-revista-neurologia-295-articulo-sindrome-guillain-barre-como-forma-presentacion-S0213485320302085
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Published
2022-01-17
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Aguiar-González AM, Roque-Pérez L, Mojena-Roblejo M. Neurological manifestations in patients with COVID-19. Univ. Méd. Pinareña [Internet]. 2022 Jan. 17 [cited 2025 Jun. 26];18(2):e675. Available from: https://revgaleno.sld.cu/index.php/ump/article/view/675
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