Neuropathogenesis and Neurologic Manifestations of the Coronaviruses in the Age of Coronavirus Disease 2019

Abstract

A novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged from Wuhan, China, in December 2019, resulting in a severe outbreak of pneumonia¹; SARS-CoV-2 causes a clinical syndrome, coronavirus disease 2019 (COVID-19), and its pulmonary manifestations have been well described. There is growing evidence of neurological complications and disease in patients with COVID-19. Two similar human coronaviruses (CoV), Middle East respiratory syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS-CoV-1), have also been associated with neurological disease in rare cases. This raises the questions of whether SARS-CoV-2 is neurotropic and whether it contributes to postinfectious neurologic complications. A handful of case reports have described neurological complications in patients with COVID-19.^1-4 However, it remains unknown to what extent SARS-CoV-2 damages the central nervous system (CNS) or if neurological symptoms are attributable to secondary mechanisms.