Neurological features of COVID-19 and their treatment: a review

Article Details

Authors
Daniele Orsucci MD, Elena Caldarazzo Ienco MD, Gianpaolo Nocita MD, Alessandro Napolitano MD, Marco Vista MD

Article Type
Review

DOI
10.7573/dic.2020-5-1

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Abstract

Severe acute respiratory syndrome–correlated new coronavirus (SARS-Cov-2) infection may result in neurological signs and symptoms through different mechanisms. Although direct infection of the central nervous system is uncertain or very rare and the para-infectious complications (e.g. inflammatory neuropathies) are rare, delirium and septic encephalopathy are common in severely ill patients. Smell dysfunction and headache are very common in mild cases, especially in younger people and females. Muscle pain is common in both mild and severe cases, and in the most compromised patients, it is accompanied by increased creatine kinase levels and by a likely true myopathic damage. Ischemic stroke has been reported as a possible complication of the hypercoagulability associated with severe SARS-Cov-2 infection, but further studies are needed. Most of the neurological manifestations may occur early in the illness. Therefore, during the pandemic period, neurologists need to be involved, alert, and prepared. Neurological practice will not be the same until a vaccine is available.

Keywords: anosmia, coronavirus, COVID-19, CPK, Guillain–Barré syndrome, myopathy, myositis, Sars-Cov-2, stroke.

Citation: Orsucci D, Caldarazzo Ienco E, Nocita G, Napolitano A, Vista M. Neurological features of COVID-19 and their treatment: a review. Drugs in Context 2020; 9: 2020-5-1. DOI: 10.7573/dic.2020-5-1

Contributions: All authors contributed to the preparation of this review. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2020/05/dic.2020-5-1-COI.pdf

Acknowledgements: The authors are grateful to Dr Alessandro Taliani (Unit of Radiology, San Luca Hospital, Lucca, Italy) for the technical support.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2020 Orsucci D, Caldarazzo Ienco E, Nocita G, Napolitano A, Vista M. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2020 Orsucci D, Caldarazzo Ienco E, Nocita G, Napolitano A, Vista M. https://doi.org/10.7573/dic.2020-5-1. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/neurological-features-of-covid-19-and-their-treatment:-a-review

Correspondence: Daniele Orsucci, Unit of Neurology, San Luca Hospital of Lucca, Via Lippi-Francesconi, 55100 Lucca, Italy. orsuccid@gmail.com

Provenance: invited; externally peer reviewed.

Submitted: 4 May 2020; Peer review comments to author: 23 May 2020; Revised manuscript received: 29 May 2020; Accepted: 29 May 2020; Publication date: 11 June 2020.

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