COVID-19, SARS and MERS: A neurological perspective. (July 2020)

• Record Type: Journal Article
• Authors: Ng Kee Kwong, Koy Chong; Mehta, Puja R.; Shukla, Garima; Mehta, Arpan R.
• Is Part Of: Journal of clinical neuroscience. Volume 77(2020)
• Page Start: 13
• Page End: 16
• Publication Date: 2020-07
• Subjects: Coronavirus -- COVID-19 -- MERS -- Neurology -- Neurotropism -- SARS; 2019-nCoV 2019 novel coronavirus -- ACE2 angiotensin-converting enzyme 2 -- ARDS acute respiratory distress syndrome -- CNS central nervous system -- COVID-19 Coronavirus Disease 19 -- CRP C-reactive protein -- CSF cerebrospinal fluid -- DPP4 dipeptidyl peptidase 4 -- MERS-CoV Middle East respiratory syndrome coronavirus -- PNS peripheral nervous system -- SARS-CoV severe acute respiratory syndrome coronavirus -- SARS-CoV-2 severe acute respiratory syndrome coronavirus 2 -- WHO World Health Organisation; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2020.04.124
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: COVID-19 is caused by a highly pathogenic coronavirus named "SARS-CoV-2". COVID-19 pathophysiology is primarily defined by acute respiratory illness. Several studies have revealed a possible neurological component to COVID-19. Various neurological manifestations have also been reported for SARS and MERS. Further research into the importance of neurological manifestations in COVID-19 is needed. Abstract: Central to COVID-19 pathophysiology is an acute respiratory infection primarily manifesting as pneumonia. Two months into the COVID-19 outbreak, however, a retrospective study in China involving more than 200 participants revealed a neurological component to COVID-19 in a subset of patients. The observed symptoms, the cause of which remains unclear, included impaired consciousness, skeletal muscle injury and acute cerebrovascular disease, and appeared more frequently in severe disease. Since then, findings from several studies have hinted at various possible neurological outcomes in COVID-19 patients. Here, we review the historical association between neurological complications and highly pathological coronaviruses including SARS-CoV, MERS-CoV and SARS-CoV-2. We draw from evidence derived from past coronavirus outbreaks, noting the similarities and differences between SARS and MERS, and the current COVID-19 pandemic. We end by briefly discussing possible mechanisms by which the coronavirus impacts on the human nervous system, as well as neurology-specific considerations that arise from the repercussions of COVID-19.