Neurological manifestations of COVID-19: pathogenesis, diagnosis, and management
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The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to cause substantial morbidity and mortality worldwide. The first part of this thesis will review the background of SARS-CoV-2 and the potential mechanisms of neuroinvasion. The cytokine storm is implicated in the pathogenesis of many of the neurological conditions discussed in this paper. The molecular and histological evidence further support the possible association of SARS-CoV-2 with these conditions. Next, the diagnosis and therapeutic interventions of neurological conditions of SARS-CoV-2 will be investigated. The neurological manifestations associated with COVID-19 will be divided into two categories, acute and long-term sequelae. The acute COVID-19 associated neurological conditions reviewed include Guillain-Barré syndrome, seizures, strokes, anosmia, multisystem inflammatory syndrome in children (MIS-C), and multisystem inflammatory syndrome in adults (MIS-A). The long-term neurological sequelae of COVID-19 discussed include a psychiatric disorder, depression and a neurodegenerative disorder, Alzheimer’s disease (AD). The review of the current literature suggests that COVID-19 could be associated with acute neurological diseases. However, the long-term sequelae of COVID-19 needs further investigation since this is a novel virus and there is limited evidence currently. However, the evidence continues to grow as more clinicians and researchers recognize the extrapulmonary manifestations of COVID-19. An awareness of the neurological impact this disease can have is critical for patient management and the appropriate public health response. Having a better understanding of the neurological impact of this disease will help to reduce the morbidity and mortality associated with SARS-CoV-2 infection.