Acute and post-acute neurological manifestations of COVID-19: present findings, critical appraisal, and future directions.

Abstract

Acute and post-acute neurological symptoms, signs and diagnoses have been documented in an increasing number of patients infected by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which causes Coronavirus Disease 2019 (COVID-19). In this review, we aimed to summarize the current literature addressing neurological events following SARS-CoV-2 infection, discuss limitations in the existing literature and suggest future directions that would strengthen our understanding of the neurological sequelae of COVID-19. The presence of neurological manifestations (symptoms, signs or diagnoses) both at the onset or during SARS-CoV-2 infection is associated with a more severe disease, as demonstrated by a longer hospital stay, higher in-hospital death rate or the continued presence of sequelae at discharge. Although biological mechanisms have been postulated for these findings, evidence-based data are still lacking to clearly define the incidence, range of characteristics and outcomes of these manifestations, particularly in non-hospitalized patients. In addition, data from low- and middle-income countries are scarce, leading to uncertainties in the measure of neurological findings of COVID-19, with reference to geography, ethnicity, socio-cultural settings, and health care arrangements. As a consequence, at present a specific phenotype that would specify a post-COVID (or long-COVID) neurological syndrome has not yet been identified.

• Authors: Ettore Beghi, Giorgia Giussani, Erica Westenberg, Ricardo Allegri, David Garcia-Azorin, Alla Guekht, Jennifer Frontera, Miia Kivipelto, Francesca Mangialasche, Elizabeta B Mukaetova-Ladinska, Kameshwar Prasad, Neerja Chowdhary, Andrea Sylvia Winkler
• Journal: Journal of neurology (J Neurol) Vol. 269 Issue 5 Pg. 2265-2274 (May 2022) ISSN: 1432-1459 [Electronic] Germany
• PMID: 34674005 (Publication Type: Journal Article, Review)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

Topics

• COVID-19 (complications)
• Hospital Mortality
• Humans
• Nervous System Diseases (epidemiology, etiology)
• SARS-CoV-2
• Post-Acute COVID-19 Syndrome