A spectrum of neurological disease associated with COVID-19 is becoming increasingly apparent. However, the mechanisms behind these manifestations remain poorly understood, significantly hindering their management. The present review subsequently attempts to address the evolving molecular, cellular and systemic mechanisms of NeuroCOVID, which we have classified as the acute and long-term neurological effects of COVID-19. We place particular emphasis on cerebrovascular, demyelinating and encephalitic presentations, which have been reported. Several mechanisms are presented, especially the involvement of a “cytokine storm”. We explore the genetic and demographic factors that may predispose individuals to NeuroCOVID. The increasingly evident long-term neurological effects are also presented, including the impact of the virus on cognition, autonomic function and mental wellbeing, which represent an impending burden on already stretched healthcare services. We subsequently reinforce the need for cautious surveillance, especially for those with predisposing factors, with effective clinical phenotyping, appropriate investigation and, if possible, prompt treatment. This will be imperative to prevent downstream neurological sequelae, including those related to the long COVID phenotypes that are being increasingly recognised.

与 COVID-19 相关的一系列神经系统疾病正变得越来越明显。然而，这些表现背后的机制仍然知之甚少，严重阻碍了它们的管理。本综述随后试图解决 NeuroCOVID 不断发展的分子、细胞和系统机制，我们将其归类为 COVID-19 的急性和长期神经系统影响。我们特别强调已报告的脑血管、脱髓鞘和脑炎表现。提出了几种机制，尤其是“细胞因子风暴”的参与。我们探讨了可能使个体易患 NeuroCOVID 的遗传和人口统计因素。还介绍了越来越明显的长期神经系统影响，包括病毒对认知的影响，自主功能和心理健康，这对已经不堪重负的医疗服务来说是迫在眉睫的负担。我们随后强调了谨慎监测的必要性，特别是对于那些有易感因素的患者，要进行有效的临床表型分析、适当的调查，并在可能的情况下及时治疗。这对于防止下游神经系统后遗症至关重要，包括那些与越来越多的人认识到的长 COVID 表型相关的后遗症。