Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.
As of April 9, 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had infected 1,436,198 people and caused 85,522 deaths. By the time you read this, those numbers will have increased. As the numbers grow, more and more neurologic symptoms are being reported in COVID-19 patients. Neurologists, in turn, may increasingly find themselves involved in caring for patients with the novel virus.
COVID-19 may affect the nervous system via four potential mechanisms, which may overlap. The first is direct viral injury of nervous tissue, such as occurs with herpes simplex encephalitis. Although there are some suggestive case reports, there is no definite proof that the SARS-CoV-2 virus directly damages the central nervous system (CNS).
The second type of injury results from an excessive immune response in the form of a "cytokine storm." Cytokines can cross the blood-brain barrier and are associated with acute necrotizing encephalopathy. Only one case concurrent with COVID-19 has been reported.
The third mechanism of nervous tissue damage results from unintended host immune response effects after an acute infection. An example of this type of indirect CNS injury is Guillain-Barré syndrome(GBS). One case of GBS associated with COVID-19 has been reported, but the evidence for cause and effect is weak.
