Abstract

Anosmia, stroke, paralysis, cranial nerve deficits, encephalopathy, delirium, meningitis, and seizures are some of the neurological complications in patients with coronavirus disease-19 (COVID-19) which is caused by acute respiratory syndrome coronavirus 2 (SARS-Cov2). There remains a challenge to determine the extent to which neurological abnormalities in COVID-19 are caused by SARS-Cov2 itself, the exaggerated cytokine response it triggers, and/or the resulting hypercoagulapathy and formation of blood clots in blood vessels throughout the body and the brain. In this article, we review the reports that address neurological manifestations in patients with COVID-19 who may present with acute neurological symptoms (e.g., stroke), even without typical respiratory symptoms such as fever, cough, or shortness of breath. Next, we discuss the different neurobiological processes and mechanisms that may underlie the link between SARS-Cov2 and COVID-19 in the brain, cranial nerves, peripheral nerves, and muscles. Finally, we propose a basic “NeuroCovid” classification scheme that integrates these concepts and highlights some of the short-term challenges for the practice of neurology today and the long-term sequalae of COVID-19 such as depression, OCD, insomnia, cognitive decline, accelerated aging, Parkinson’s disease, or Alzheimer’s disease in the future. In doing so, we intend to provide a basis from which to build on future hypotheses and investigations regarding SARS-Cov2 and the nervous system.

中文翻译：

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COVID-19 的神经生物学。

摘要

嗅觉丧失、中风、瘫痪、颅神经缺损、脑病、谵妄、脑膜炎和癫痫是由急性呼吸综合征冠状病毒 2 (SARS-Cov2) 引起的冠状病毒病 19 (COVID-19) 患者的一些神经系统并发症。确定 COVID-19 中的神经系统异常在多大程度上是由 SARS-Cov2 本身、其引发的过度细胞因子反应和/或由此导致的全身和全身血管中的高凝状态和血栓形成仍然是一个挑战。脑。在本文中，我们回顾了有关 COVID-19 患者神经系统表现的报告，这些患者可能出现急性神经系统症状（例如中风），即使没有典型的呼吸道症状，例如发烧、咳嗽或呼吸急促。接下来，我们讨论可能构成 SARS-Cov2 和 COVID-19 在大脑、颅神经、周围神经和肌肉中联系的不同神经生物学过程和机制。最后，我们提出了一个基本的“NeuroCovid”分类方案，该方案整合了这些概念，并强调了当今神经病学实践的一些短期挑战以及 COVID-19 的长期后遗症，如抑郁、强迫症、失眠、认知能力下降，加速衰老，帕金森病，或者未来的阿尔茨海默病。在此过程中，我们打算为未来关于 SARS-Cov2 和神经系统的假设和研究奠定基础。