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Neurological Complications of COVID-19 and Possible Neuroinvasion Pathways: A Systematic Review

Department of Surgical, Medical and Molecular & Critical Area Pathology, University of Pisa, via Savi 10, 56126 Pisa, Italy
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(18), 6688;
Received: 4 August 2020 / Revised: 9 September 2020 / Accepted: 10 September 2020 / Published: 14 September 2020
(This article belongs to the Special Issue Applying Clinical Psychology to Medical Conditions)
The Coronavirus Disease 2019 (COVID-19) outbreak has shocked the whole world with its unexpected rapid spread. The virus responsible for the disease, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), enters host cells by means of the envelope spike protein, which binds to angiotensin-converting enzyme 2 receptors. These receptors are highly expressed in heart, lungs, respiratory tract epithelium, endothelial cells and brain. Since an increasing body of significant evidence is highlighting a possible neuroinvasion related to SARS-CoV-2, a state of the art on the neurological complications is needed. To identify suitable publications, our systematic review was carried out by searching relevant studies on PubMed and Scopus databases. We included studies investigating neurologic manifestations of SARS-CoV-2 in patients over 18. According to the analyzed studies, the most frequent disorders affecting central nervous system (CNS) seem to be the following: olfactory and taste disorders, ischemic/hemorrhagic stroke, meningoencephalitis and encephalopathy, including acute necrotizing encephalopathy, a rare type of encephalopathy. As regards the peripheral nervous system (PNS), Guillain-Barré and Miller Fisher syndromes are the most frequent manifestations reported in the literature. Important clinical information on the neurological manifestations of SARS-CoV-2 would help clinicians raise awareness and simultaneously improve the prognosis of critically ill patients. View Full-Text
Keywords: COVID-19; SARS-CoV-2; neurologic complications COVID-19; SARS-CoV-2; neurologic complications
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Orrù, G.; Conversano, C.; Malloggi, E.; Francesconi, F.; Ciacchini, R.; Gemignani, A. Neurological Complications of COVID-19 and Possible Neuroinvasion Pathways: A Systematic Review. Int. J. Environ. Res. Public Health 2020, 17, 6688.

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