The Neurological Complexities and Prognosis of COVID-19
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COVID-19
The Neurological Complexities and Prognosis of COVID-19 Inderbir Padda 1 & Nimrat Khehra 2 & Urooj Jaferi 3 & Mayur S. Parmar 4 Accepted: 17 September 2020 # Springer Nature Switzerland AG 2020
Abstract Several neurological manifestations and complications linked to SARS-CoV-2 have been reported along with well-known respiratory pathology. The global active transmission of SARS-CoV-2 and its unexplained characteristics has led to a pandemic. Since its rapid emergence from Wuhan, China, in December 2019, several studies have reported the impacts of COVID-19 on the CNS and PNS and its implications. This comprehensive review article comprises case reports, case series, metaanalysis, cohort studies, retrospective studies, and narrative reviews focusing on COVID-19-associated CNS and PNS complexities. The authors searched for over 200 articles and used 52 publications related to the neurological complexities of COVID-19 affecting the CNS and PNS as part of the literature review process. The predominant CNS symptoms noted in COVID-19 patients were headaches and dizziness, and the most common PNS symptoms were alterations in smell and taste. Case reports on headache/dizziness, intracerebral hemorrhage, acute hemorrhagic necrotizing encephalopathy, meningitis/encephalitis, encephalopathy, cerebrovascular events, chemosensory dysfunction, Guillain–Barre syndrome, and acute transverse myelitis/acute necrotizing myelitis in PCR-confirmed SARS-CoV-2 subjects are also reported. New-onset neurological symptoms were also observed in children with PCR-confirmed SARS-CoV-2 that developed pediatric multisystem inflammatory syndrome (PIMS). This comprehensive review article will assist the clinicians and researchers to gain information about the neurological manifestations and complications associated with COVID-19 and develop planning to treat these symptoms in concerned patients of all ages. However, it is unclear whether SARS-CoV2-associated neurological effects are due to primary infections or secondary response to the possible mechanisms discussed in this review. Keywords COVID-19 . SARS-CoV-2 . Coronavirus . Mechanisms . Pathophysiology . Neurologic manifestations . Neurologic complications . CNS symptoms . PNS symptoms . Cerebrovascular disease . Encephalopathy . Viral encephalitis . Meningitis . Neurological signs and symptoms . Systematic literature review . Literature review
Introduction COVID-19 is a rapidly emerging RNA virus since its first reported case in Wuhan, China, in December 2019 [1, 2]. This article is part of the Topical Collection on Covid-19 * Inderbir Padda [email protected] * Mayur S. Parmar [email protected] 1
University of Washington, Seattle, WA, USA
2
Caribbean Medical University School of Medicine, Willemstad, Curaçao
3
All Saints University School of Medicine, Roseau, Dominica
4
Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Tampa Bay Campus, Clearwater, FL, USA
On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic
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