Abstract A comprehensive review of the neurological disorders reported during the current COVID-19 pandemic demonstrates that infection with SARS-CoV-2 affects the central nervous system (CNS), the peripheral nervous system (PNS) and the muscle. CNS manifestations include: headache and decreased responsiveness considered initial indicators of potential neurological involvement; anosmia, hyposmia, hypogeusia, and dysgeusia are frequent early symptoms of coronavirus infection. Respiratory failure, the lethal manifestation of COVID-19, responsible for 215,461 deaths worldwide, is probably neurogenic in origin and may result from the viral invasion of cranial nerve I, progressing into rhinencephalon and brainstem respiratory centers. Cerebrovascular disease, in particular large-vessel ischemic strokes, and less frequently cerebral venous thrombosis, intracerebral hemorrhage and subarachnoid hemorrhage, usually occur as part of a thrombotic state induced by viral attachment to ACE2 receptors in endothelium causing widespread endotheliitis, coagulopathy, arterial and venous thromboses. Acute hemorrhagic necrotizing encephalopathy is associated to the cytokine storm. A frontal hypoperfusion syndrome has been identified. There are isolated reports of seizures, encephalopathy, meningitis, encephalitis, and myelitis. The neurological diseases affecting the PNS and muscle in COVID-19 are less frequent and include Guillain-Barré syndrome; Miller Fisher syndrome; polyneuritis cranialis; and rare instances of viral myopathy with rhabdomyolysis. The main conclusion of this review is the pressing need to define the neurology of COVID-19, its frequency, manifestations, neuropathology and pathogenesis. On behalf of the World Federation of Neurology we invite national and regional neurological associations to create local databases to report cases with neurological manifestations observed during the on-going pandemic. International neuroepidemiological collaboration may help define the natural history of this worldwide problem.

中文翻译：

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重新审视 COVID-19 的神经病学：世界神经病学联合会环境神经病学专业小组提出的实施国际神经病学登记的提案

摘要 对当前 COVID-19 大流行期间报告的神经系统疾病的全面审查表明，SARS-CoV-2 感染会影响中枢神经系统 (CNS)、周围神经系统 (PNS) 和肌肉。CNS 表现包括： 头痛和反应性降低被认为是潜在神经系统受累的初始指标；嗅觉丧失、嗅觉减退、味觉减退和味觉障碍是冠状病毒感染的常见早期症状。呼吸衰竭是 COVID-19 的致命表现，导致全球 215,461 人死亡，其起源可能是神经源性的，可能是由于病毒入侵 I 颅神经，进展到鼻脑和脑干呼吸中枢所致。脑血管疾病，特别是大血管缺血性中风，以及较少见的脑静脉血栓形成，脑内出血和蛛网膜下腔出血，通常作为血栓形成状态的一部分发生，由病毒附着在内皮中的 ACE2 受体引起，导致广泛的内皮炎、凝血病、动脉和静脉血栓形成。急性出血性坏死性脑病与细胞因子风暴有关。已经确定了额叶低灌注综合征。有癫痫、脑病、脑膜炎、脑炎和脊髓炎的孤立报告。COVID-19 中影响 PNS 和肌肉的神经系统疾病较少见，包括吉兰-巴雷综合征；米勒费舍尔综合征; 颅多发性神经炎; 和罕见的病毒性肌病伴横纹肌溶解症。本综述的主要结论是迫切需要定义 COVID-19 的神经学、其频率、表现、神经病理学和发病机制。我们代表世界神经病学联合会邀请国家和地区神经病学协会创建本地数据库，以报告在持续大流行期间观察到的具有神经学表现的病例。国际神经流行病学合作可能有助于确定这一全球性问题的自然史。