Zhixing Xu1 · Hui Wang2 · Siya Jiang3 · Jiao Teng4 · Dongxu Zhou5 · Zhong Chen2,6 · Chengping Wen7 · Zhenghao Xu6,71 First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China
2 School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China
3 Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou 310053, China
4 Afliated Lin’an People’s Hospital of Hangzhou Medical College, First People’s Hospital of Hangzhou Lin’an District, Lin’an, Hangzhou 311300, China
5 School of Life Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China
6 Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, College of Pharmaceutical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
7 Laboratory of Rheumatology and Institute of TCM Clinical Basic Medicine, College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou 310053, China
Abstract
Neurological manifestations of coronavirus disease 2019 (COVID-19) are less noticeable than the respiratory symptoms, but they may be associated with disability and mortality in COVID-19. Even though Omicron caused less severe disease than Delta, the incidence of neurological manifestations is similar. More than 30% of patients experienced “brain fog”, delirium, stroke, and cognitive impairment, and over half of these patients presented abnormal neuroimaging outcomes. In this review, we summarize current advances in the clinical findings of neurological manifestations in COVID-19 patients and compare them with those in patients with influenza infection. We also illustrate the structure and cellular invasion mechanisms of SARS-CoV-2 and describe the pathway for central SARS-CoV-2 invasion. In addition, we discuss direct damage and other pathological conditions caused by SARS-CoV-2, such as an aberrant interferon response, cytokine storm, lymphopenia, and hypercoagulation, to provide treatment ideas. This review may offer new insights into preventing or treating brain damage in COVID-19.
Keywords
COVID-19; SARS-CoV-2; Brain; Neurological pathology
