This article constitutes a summary of the knowledge on the involvement of the nervous system in COVID-19, concerning its general pathobiology, clinical presentation and neuropathological features as well as the future directions of investigation. Variable definitions, selection bias, mainly retrospective analyses of hospitalized patients and different methodologies are implemented in the research of this new disease. Central nervous system (CNS) pathology presents most frequently features of non-specific neuroinflammation with microglial activation and lymphoid infiltrations, ischemic/hypoxic encephalopathy, acute cerebrovascular disease, and microthrombi. Some brain specimens remain unaffected or show only non-specific changes of the critical status. Interpretations of the neuropathological findings are not always balanced in a clinical context and discrepant in consequence. Designing of longitudinal neuropathological studies, more frequent autopsies, and building of COVID-19 brain banks, together with neuroimaging analyses is essential. Genetic predispositions or immunological factors corresponding to the disease profile as well as cerebrospinal fluid (CSF) or serum biomarkers of COVID-19, the impact of different virus variants and influence of the therapy need to be identified. The mechanisms causing neuroCOVID and cognitive impairment – whether they are infectious, toxic, vascular or metabolic – create other aspects under research. There are also many existential questions about post-COVID and delayed sequelae of the infection. The fight with pandemic is a challenge for the global society, with neuropathologists and neuroscientists as important allies in struggle for understanding and conquering COVID-19.

中文翻译：

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COVID-19 –大流行斗争后第一年的神经病理学观点，病理生物学和困境

本文构成了有关COVID-19中神经系统参与的知识的摘要，涉及其一般病理生物学，临床表现和神经病理学特征以及未来的研究方向。在这种新疾病的研究中，实施了变量定义，选择偏倚，主要是对住院患者的回顾性分析以及不同的方法。中枢神经系统（CNS）病理最常表现为非特异性神经炎症，包括小胶质细胞活化和淋巴样浸润，缺血/缺氧性脑病，急性脑血管疾病和微血栓。一些脑标本保持不受影响或仅显示临界状态的非特定变化。神经病理学发现的解释在临床环境中并不总是平衡的，其结果也不尽相同。纵向神经病理学研究的设计，更频繁的尸检，COVID-19脑库的建立以及神经影像分析是必不可少的。需要确定与疾病状况以及脑脊髓液（CSF）或COVID-19的血清生物标志物相对应的遗传易感性或免疫学因素，不同病毒变体的影响以及治疗的影响。导致NeuroCOVID和认知障碍的机制（无论是传染性，中毒性，血管性还是代谢性）在研究中创造了其他方面。关于COVID后和感染后遗症也存在许多存在的问题。与流行病作斗争是全球社会的挑战，