Lifting the mask on neurological manifestations of COVID-19
Open accessAbstract
As the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic spreads, it is becoming increasingly evident that coronavirus disease 2019 (COVID-19) is not limited to the respiratory system, and that other organs can be affected. In particular, virus-related neurological manifestations are being reported more and more frequently in the scientific literature. In this article, we review the literature on the association between COVID-19 and neurological manifestations, present evidence from preclinical research suggesting that SARS-CoV-2 could be responsible for many of these manifestations, and summarize the biological pathways that could underlie each neurological symptom. Understanding the mechanisms that lead to neurological manifestations in patients with COVID-19 and how these manifestations correlate with clinical outcomes will be instrumental in guiding the optimal use of targeted therapeutic strategies.
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Neurological manifestations affect between 4.2 and 100% of studied COVID-19 patients.
“As reviewed by Pezzini and Padovani, neurological manifestations affect between 4.2 and 100% of studied patients: dizziness (prevalent in 7.6–46.1%), headache (5.1–77.1%), impaired consciousness (9.5–64.1%), and seizures (1.2–26%) [22].”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [22]
In COVID-19 patients presenting at least one neurological symptom, the prevalence of acute stroke (2.9-76.8%), confusion (14.2-65%), and encephalitis (0-27.9%) stands out.
“Noteworthy, in COVID-19 patients presenting at least one neurological symptom, the prevalence of acute stroke (2.9–76.8%), confusion (14.2–65%), and encephalitis (0–27.9%) stands out.”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [22]
COVID-19 patients also present impaired taste (10-19.2%), smell (6-21.7%), dysautonomia (4.3-12%), and acute inflammatory demyelinating polyneuropathy (0-16,2%).
“COVID-19 patients also present other nervous system symptoms, such as impaired taste (10–19.2%) and smell (6–21.7%), dysautonomia (4.3–12%), and acute inflammatory demyelinating polyneuropathy (0–16,2%) [22].”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [22]
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- Authors
- Pezzini, A., & Padovani, A.
- Affiliations
- University of Brescia (IT)
- Corresponding author
- Pezzini, Alessandro
- Venue
- Nature Reviews Neurology
- Published
- 2020-08-24
- Volume
- 16
- Issue
- 11
- Pages
- 636-644
- ISSN
- 1759-4758 (ISSN-L)
- 1759-4766
- PMC
- PMC7444680
- OpenAlex
- W3080497013
- Cited by
- 447
- References
- 103
- Citations by year
- 2026: 7 · 2025: 28 · 2024: 42 · 2023: 77 · 2022: 101 · 2021: 161 · 2020: 31
- FWCI
- 10.41
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Nature Reviews Neurology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Keywords
- COVID-19 pandemic, SARS-CoV-2, neurological symptoms, neuroinflammation, biological pathways, clinical outcomes, targeted therapy, neurodegeneration
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Humans, Nervous System Diseases, Pneumonia, Viral, Coronavirus Infections, Pandemics
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