Importance Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019, causing human coronavirus disease 2019 (COVID-19), which has now spread into a worldwide pandemic. The pulmonary manifestations of COVID-19 have been well described in the literature. Two similar human coronaviruses that cause Middle East respiratory syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS-CoV-1) are known to cause disease in the central and peripheral nervous systems. Emerging evidence suggests COVID-19 has neurologic consequences as well.

Observations This review serves to summarize available information regarding coronaviruses in the nervous system, identify the potential tissue targets and routes of entry of SARS-CoV-2 into the central nervous system, and describe the range of clinical neurological complications that have been reported thus far in COVID-19 and their potential pathogenesis. Viral neuroinvasion may be achieved by several routes, including transsynaptic transfer across infected neurons, entry via the olfactory nerve, infection of vascular endothelium, or leukocyte migration across the blood-brain barrier. The most common neurologic complaints in COVID-19 are anosmia, ageusia, and headache, but other diseases, such as stroke, impairment of consciousness, seizure, and encephalopathy, have also been reported.

Conclusions and Relevance Recognition and understanding of the range of neurological disorders associated with COVID-19 may lead to improved clinical outcomes and better treatment algorithms. Further neuropathological studies will be crucial to understanding the pathogenesis of the disease in the central nervous system, and longitudinal neurologic and cognitive assessment of individuals after recovery from COVID-19 will be crucial to understand the natural history of COVID-19 in the central nervous system and monitor for any long-term neurologic sequelae.

重要性严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 于 2019 年 12 月出现，引起人类冠状病毒病 2019 (COVID-19)，现已蔓延为全球大流行。文献中已经详细描述了 COVID-19 的肺部表现。已知引起中东呼吸综合征 (MERS-CoV) 和严重急性呼吸综合征 (SARS-CoV-1) 的两种类似的人类冠状病毒会引起中枢和周围神经系统疾病。新的证据表明，COVID-19 也会产生神经系统后果。

观察本综述旨在总结有关神经系统中冠状病毒的现有信息，确定 SARS-CoV-2 进入中枢神经系统的潜在组织靶点和途径，并描述迄今为止已报告的临床神经并发症的范围COVID-19 及其潜在发病机制。病毒神经侵袭可通过多种途径实现，包括跨受感染神经元的突触转移、通过嗅神经进入、血管内皮感染或白细胞穿过血脑屏障迁移。 COVID-19 最常见的神经系统症状是嗅觉丧失、味觉缺失和头痛，但也有其他疾病的报道，如中风、意识障碍、癫痫发作和脑病。

结论和相关性认识和理解与 COVID-19 相关的一系列神经系统疾病可能会改善临床结果和更好的治疗算法。进一步的神经病理学研究对于了解中枢神经系统疾病的发病机制至关重要，而对 COVID-19 康复后个体的纵向神经学和认知评估对于了解中枢神经系统中 COVID-19 的自然史至关重要并监测任何长期神经系统后遗症。