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Neuropathogenesis of SARS-CoV-2 infection

  1. Shumayila Khan
  2. James Gomes  Is a corresponding author
  1. Kusuma School of Biological Sciences, Indian Institute of Technology Delhi, India
Review Article
Cite this article as: eLife 2020;9:e59136 doi: 10.7554/eLife.59136
1 figure and 1 table

Figures

Schematic diagram showing the possible routes of neuroinvasiveness of SARS-CoV-2.

Tables

Table 1
Neurological manifestations of SARS-CoV-2 infection.
Neurological manifestationsObservationsSupportive neuro-diagnostic measuresTreatmentReferences
StrokeIschaemic stroke, deep vein thrombosisMRI, ECG, EKG; blood test for coagulation factors, inflammatory markersAntiplatelet, anticoagulant, tissue plasminogen activator, intravenous thrombolysisMao et al., 2020, Beyrouti et al., 2020, Zhou et al., 2020a, Li et al., 2020
SeizureGeneralized seizures, convulsions, tonic-clonic seizures, status- epilepticusMRI, CT scan, EEG; CSF for viral presenceAnti-epileptic medication Levetiracetam, Clonazepam and ValproateMao et al., 2020; Duong et al., 2020; Sohal and Mansur, 2020; Bernard-Valnet, 2020
EncephalopathyDisorientation, confusion hallucinations, altered mental status, agitation, irritability, dissociated speech, lethargyMRI, EEG; CSF for viral presenceTreatment for related problems such as seizuresMao et al., 2020; Poyiadji et al., 2020; Duong et al., 2020; Yin et al., 2020; Helms et al., 2020,
Encephalitis/meningitisFocal neurological defects, fever, headache, other neuropsychotic symptomsMRI, EEG; CRP levels for inflammation; CSF for viral presenceAntivirals such as Acyclovir, Favipiravir, antibiotics such as Ceftriaxone, Vancomycin, and steroidsMao et al., 2020; Bernard-Valnet, 2020; Chaumont et al., 2020; Hayashi et al., 2020
Anosmia and ageusiaReduction or loss of taste and smell, without nasal obstructionSelf diagnosisUsually no treatmentMao et al., 2020; Lechien, 2020; Hawthorn, 2018; Fotuhi et al., 2020; Galougahi et al., 2020; Spinato et al., 2020
Brain haemorrhageIntracranial blood loss, haemorrhagic rim enhancement in multiple parts of the brainMRI, CT scan; CSF for viral presenceIntravenous immunoglobulinMao et al., 2020, Poyiadji et al., 2020
Myalgia, partial paralysis and/or Guillain-Barré syndromeFacial drooping, muscle weakness, diplegia/tetraplegia or hemiplegia; GBS-progressive, ascending, symmetrical flaccid limb paralysis, along with areflexia or hyporeflexia with or without cranial nerve involvementMRI, CSF evaluation, CPK levels for muscle tissue damage, test for anti-ganglioside antibodies, nerve conduction studies for demyelinating neuropathy evaluationIntravenous immunoglobulin, physiotherapyWang 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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