Neuropathogenesis of SARS-CoV-2 infection
- Kusuma School of Biological Sciences, Indian Institute of Technology Delhi, India
Figures
Figure 1
Schematic diagram showing the possible routes of neuroinvasiveness of SARS-CoV-2.
Tables
Table 1
Neurological manifestations of SARS-CoV-2 infection.
| Neurological manifestations | Observations | Supportive neuro-diagnostic measures | Treatment | References |
|---|---|---|---|---|
| Stroke | Ischaemic stroke, deep vein thrombosis | MRI, ECG, EKG; blood test for coagulation factors, inflammatory markers | Antiplatelet, anticoagulant, tissue plasminogen activator, intravenous thrombolysis | Mao et al., 2020, Beyrouti et al., 2020, Zhou et al., 2020a, Li et al., 2020 |
| Seizure | Generalized seizures, convulsions, tonic-clonic seizures, status- epilepticus | MRI, CT scan, EEG; CSF for viral presence | Anti-epileptic medication Levetiracetam, Clonazepam and Valproate | Mao et al., 2020; Duong et al., 2020; Sohal and Mansur, 2020; Bernard-Valnet, 2020 |
| Encephalopathy | Disorientation, confusion hallucinations, altered mental status, agitation, irritability, dissociated speech, lethargy | MRI, EEG; CSF for viral presence | Treatment for related problems such as seizures | Mao et al., 2020; Poyiadji et al., 2020; Duong et al., 2020; Yin et al., 2020; Helms et al., 2020, |
| Encephalitis/meningitis | Focal neurological defects, fever, headache, other neuropsychotic symptoms | MRI, EEG; CRP levels for inflammation; CSF for viral presence | Antivirals such as Acyclovir, Favipiravir, antibiotics such as Ceftriaxone, Vancomycin, and steroids | Mao et al., 2020; Bernard-Valnet, 2020; Chaumont et al., 2020; Hayashi et al., 2020 |
| Anosmia and ageusia | Reduction or loss of taste and smell, without nasal obstruction | Self diagnosis | Usually no treatment | Mao et al., 2020; Lechien, 2020; Hawthorn, 2018; Fotuhi et al., 2020; Galougahi et al., 2020; Spinato et al., 2020 |
| Brain haemorrhage | Intracranial blood loss, haemorrhagic rim enhancement in multiple parts of the brain | MRI, CT scan; CSF for viral presence | Intravenous immunoglobulin | Mao et al., 2020, Poyiadji et al., 2020 |
| Myalgia, partial paralysis and/or Guillain-Barré syndrome | Facial drooping, muscle weakness, diplegia/tetraplegia or hemiplegia; GBS-progressive, ascending, symmetrical flaccid limb paralysis, along with areflexia or hyporeflexia with or without cranial nerve involvement | MRI, CSF evaluation, CPK levels for muscle tissue damage, test for anti-ganglioside antibodies, nerve conduction studies for demyelinating neuropathy evaluation | Intravenous immunoglobulin, physiotherapy | Wang et al., 2020b; Toscano et al., 2020; Sedaghat and Karimi, 2020; Oxley et al., 2020; Zhou et al., 2020a; Zhao et al., 2020; Camdessanche et al., 2020 |
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Neuropathogenesis of SARS-CoV-2 infection
eLife 9:e59136.
https://doi.org/10.7554/eLife.59136
