University of Geneva, Geneva, Switzerland.
Interactive Research Education and Training Association (IRETA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Adv Exp Med Biol. 2021;1318:343-353. doi: 10.1007/978-3-030-63761-3_20.
Neurological manifestations of novel coronavirus disease (COVID-19) are reported to occur in as much as 37% of the affected patients. These manifestations range from headache and dizziness to altered mental status and consciousness, anosmia, ageusia, sensory disturbances, and stroke. The mechanisms by which the neurological symptoms arise are not yet determined but may either proceed as an indirect consequence of systemic hyperinflammation or result from the direct invasion of the virus to neural and glial cells. The neural invasion can explain both the retrograde pathway of encephalitis and the early manifestation of anosmia by invading the olfactory bulb. Moreover, in the case of attacking the brain stem, it may take part in the early apnea manifestation reported by patients. Additionally, neurotropism of the virus could be the cause of acute hemorrhagic encephalitis. Hyperinflammation can have acute and prolonged effects in the nervous system, such as acute demyelination and predisposition to multiple sclerosis. Moreover, the pro-inflammatory state contributes to hypercoagulation, which in turn could result in cerebrovascular injuries in COVID-19 patients. This chapter would discuss that the neurologic manifestations of the COVID-19 are to be looked at as a multifactorial entangled phenomenon.
新型冠状病毒疾病（COVID-19）的神经系统表现据报道在多达 37%的受影响患者中发生。这些表现范围从头痛和头晕到精神状态和意识改变、嗅觉丧失、味觉丧失、感觉障碍和中风。神经系统症状出现的机制尚不确定，但可能是全身炎症反应过度的间接后果，也可能是病毒直接侵犯神经和神经胶质细胞的结果。神经入侵可以解释脑炎的逆行途径和嗅觉丧失的早期表现，因为它可以侵犯嗅球。此外，在攻击脑干的情况下，它可能参与了患者报告的早期呼吸暂停表现。此外，病毒的嗜神经性可能是急性出血性脑炎的原因。炎症反应过度会对神经系统产生急性和长期的影响，如急性脱髓鞘和多发性硬化症的易感性。此外，炎症状态会导致高凝状态，从而导致 COVID-19 患者的脑血管损伤。本章将讨论 COVID-19 的神经系统表现被视为一种多因素交织的现象。
