Neurological manifestations and neuroimaging findings in patients with SARS-CoV2—a systematic review

The Egyptian Journal of Neurology, Psychiatry and Neurosurgery

Navpreet Kaur Rajinder Singh Khurana¹  Nikita Mohan²  Sampada Sandip Vaidya³  Amrat Ayaz Ali⁴  John Joyce⁵  Muhammad Ali Fayyaz⁶  Esteban Salazar⁷  Christopher del Rio⁷ 

[1] Indira Gandhi Government Medical College & Mayo Hospital, Nagpur, Maharashtra, India;Jawaharlal Nehru Medical College, Belagavi, Karnataka, India;Kazan State Medical University, Kazan, Russia;Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan;M.S Ramaiah Medical College, Bangalore, Karnataka, India;Quaid e Azam Medical College, Bahawalpur, Pakistan;Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Monterrey Nuevo Leon, Mexico;

关键词: SARS-CoV 2;    Stroke;    Neuro-invasive;    COVID-19;    Neuroimaging;   

DOI  :  10.1186/s41983-021-00322-3

来源: Springer

【 摘 要 】

BackgroundThe COVID-19 pandemic has drastically affected everyone in a hit or miss manner. Since it began, evidence of the neuro-invasive potential of the virus has been intensifying significantly. Several pathways have been hypothesized to elucidate the neurotropic nature of SARS-CoV2. It is the need of the hour to collect vital information.ObjectiveTo evaluate and correlate the neuro-radiological and neurological manifestations in patients diagnosed with SARS-CoV2.To identify neuro-invasive pathways of COVID infection.MethodsRelevant studies were identified through four databases—the Cochrane Library, PubMed, Science Direct, and Web of Science. These were searched using relevant keywords—“COVID-19,” “SARS-CoV2,” “neurological manifestations,” “neuroimaging,” “CT,” and “MRI.” Relevant articles were screened according to a pre-defined inclusion and exclusion criteria from December 2019 to August 2020.ResultsOur review included a total of 63 full text publications with 584 patients, composed mainly of observational studies, case reports, and case series. The most common neurological manifestations associated with COVID-19 were altered mental status, stroke, and paralysis. About 17.85% patients who underwent neuroimaging were found to be having ischemic changes suggestive of a stroke. This was followed by hemorrhagic changes as the second most common finding. The most commonly involved vessel was the Middle Cerebral Artery. Besides stroke, we found that SARS-CoV2 could be the cause for new-onset seizures, Guillain-Barre Syndrome, encephalitis, and many other severe neurological diseases.ConclusionThe information that we have obtained so far will prove dynamic to healthcare providers working against the COVID-19 pandemic. It is necessary to be aware of these atypical neurological findings for the early diagnosis and treatment of COVID-19 infected patients. However, to completely understand the connection between SARS-CoV2 and the nervous system, further research is necessary.

【 授权许可】

CC BY