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

BEGHI, ETTORE; GIUSSANI, GIORGIA; WESTENBERG, ERICA; ALLEGRI, RICARDO; GARCIA-AZORIN, DAVID; GUEKHT, ALLA; FRONTERA, JENNIFER; KIVIPELTO, MIIA; MANGIALASCHE, FRANCESCA; MUKAETOVA-LADINSKA, ELIZABETA B.; PRASAD, KAMESHWAR; CHOWDHARY, NEERJA; WINKLER, ANDREA SYLVIA

JOURNAL OF NEUROLOGY

DR DIETRICH STEINKOPFF VERLAG

Año: 2022 vol. 269 p. 2265 - 2274

0340-5354

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.