Jardim Vaz de Mello Leonardo, Guimaraes Silva Emylle, Oliveira Correa Rabelo Gabriel, Evaristo Leite Mariana, Vieira Nathalia Ramos, Bahadori Maryam, Seifi Ali, Godoy Daniel Agustin
Department of Medicine, School of Medicine, Federal University of Sao Joao del-Rei (UFSJ), Sao Joao del-Rei Campus, Sao Joao del-Rei, Brazil.
Departmento de Neurologia, Universidad Federal de Sao Joao del-Rei, Plaza Frei Orlando 170, Centro Sao Joao del-Rei, Minas Gerais, CEP: 36307-352, Brazil.
J Neurol Res. 2020 Oct;10(5):164-172. doi: 10.14740/jnr619. Epub 2020 Sep 4.
Coronavirus disease 2019 (COVID-19) disease caused by a new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been associated with many neurological symptoms. The purpose of this article is to describe the neurological manifestations so far reported and their probable pathogenesis. We conducted a literature review on EMBASE, MEDLINE and SCIELO databases using the terms "COVID-19", "COVID", "neurological", "neurologic", "manifestations", "implications", "Guillain-Barre syndrome", "encephalopathy". A total of 33 articles including clinical series, retrospective studies, and case reports were selected and thoroughly reviewed to describe neurological manifestations of COVID-19. There are several neurological manifestations of SARS-CoV-2 infection with different clinical presentations, severity, and prevalence. The most critical ones, such as cerebrovascular disease, encephalopathy, and Guillain-Barre syndrome, were less common and usually associated with previous medical history, known risk factors for cerebrovascular disease or advanced age. The main hypotheses for the spread of the virus are through the hematogenous route or the cribriform plate of the ethmoid bone or a disseminated severe immune response by a cytokine storm. The presence of neurological disturbances associated with laboratory tests alterations is an important clue for the physicians to promptly recognize neurological manifestations of SARS-CoV-2.
2019冠状病毒病（COVID-19）由一种新型冠状病毒——严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起，与许多神经系统症状有关。本文旨在描述目前已报道的神经系统表现及其可能的发病机制。我们在EMBASE、MEDLINE和SCIELO数据库中进行了文献综述，使用了“COVID-19”“COVID”“神经学的”“神经病学的”“表现”“影响”“吉兰-巴雷综合征”“脑病”等检索词。共筛选出33篇包括临床系列研究、回顾性研究和病例报告的文章，并进行了全面审查，以描述COVID-19的神经系统表现。SARS-CoV-2感染有多种神经系统表现，临床表现、严重程度和患病率各不相同。最严重的表现，如脑血管疾病、脑病和吉兰-巴雷综合征，较为少见，通常与既往病史、已知的脑血管疾病危险因素或高龄有关。病毒传播的主要假说是通过血行途径、筛骨筛板或细胞因子风暴引发的弥漫性严重免疫反应。与实验室检查结果改变相关的神经功能障碍的出现，是医生及时识别SARS-CoV-2神经系统表现的重要线索。
