Abstract Background Increasing research reports neurological manifestations of COVID-19 patients. SARS-CoV-2 shares homology with other human coronaviruses that have also had nervous system involvement. Objective To review the neurological aspects of SARS-cov2 and other coronavirus, including transmission pathways, mechanisms of invasion into the nervous system, and mechanisms of neurological disease. Methods We conducted a systematic review of articles in PubMed, SCOPUS and EMBASE data bases. Reviewed evidence is presented in sections of this manuscript which includes pathogenesis, neuro-invasion, encephalitis, Guillain-Barré, ADEM, multiple sclerosis, polyneuropathy, and cerebrovascular disease. Results A total 67 studies were included in the final analysis of experimental studies, case reports, series of cases, cohort studies, and systematic reviews related to neurological manifestations of SARS- CoV-2 and other human coronavirus infections. The SARS-CoV-2 receptor is expressed in the nervous system. Common reported symptoms included hyposmia, headaches, weakness, altered consciousness. Encephalitis, demyelination, neuropathy, and stroke have been associated with COVID-19. Infection through the cribriform plate and olfactory bulb and dissemination through trans-synaptic transfer are some of the mechanisms proposed. Invasion of the medullary cardiorespiratory center by SARS-CoV-2 may contribute to the refractory respiratory failure observed in critically-ill COVID-19 patients. Conclusion An increasing number of reports of COVID-19 patients with neurological disorders add to emergent experimental models with neuro-invasion as a reasonable concern that SARS-CoV-2 is a new neuropathogen. How it may cause acute and chronic neurologic disorders needs to be clarified in future research.

中文翻译：

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COVID-19 和其他冠状病毒感染的神经系统表现：系统评价

摘要背景越来越多的研究报告了 COVID-19 患者的神经系统表现。SARS-CoV-2 与其他也有神经系统受累的人类冠状病毒具有同源性。目的回顾SARS-cov2和其他冠状病毒的神经学方面，包括传播途径、侵入神经系统的机制和神经系统疾病的机制。方法 我们对 PubMed、SCOPUS 和 EMBASE 数据库中的文章进行了系统审查。本手稿的部分内容提供了经过审查的证据，其中包括发病机制、神经侵袭、脑炎、格林-巴利、ADEM、多发性硬化、多发性神经病和脑血管疾病。结果 共有 67 项研究进入实验研究、病例报告、病例系列、队列研究、以及与 SARS-CoV-2 和其他人类冠状病毒感染的神经系统表现相关的系统评价。SARS-CoV-2受体在神经系统中表达。常见的报告症状包括嗅觉减退、头痛、虚弱、意识改变。脑炎、脱髓鞘、神经病变和中风与 COVID-19 相关。通过筛板和嗅球感染以及通过跨突触转移传播是提出的一些机制。SARS-CoV-2 对延髓心肺中枢的侵袭可能导致在重症 COVID-19 患者中观察到的难治性呼吸衰竭。结论 越来越多关于 COVID-19 神经系统疾病患者的报告增加了具有神经入侵的紧急实验模型，这是对 SARS-CoV-2 是一种新的神经病原体的合理担忧。在未来的研究中需要澄清它如何导致急性和慢性神经系统疾病。