The COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), has predominant clinical presentation with respiratory disease or acute pneumonia, but neurological manifestations and complications have started being reported just recently.
During recent year of pandemic more clinical reports and growing evidence proves the involvement of peripheric nervous system in COVID-19 virus induced and mediated inflammation, with threatening increase of numbers of patients with acute demyelinating polyneuropathies, or GuillainBarré syndrome; moreover, SARS-CoV-2 has been detected in the CSF of some patients; leading to development of Critical Illness Polyneuropathies in many of patients in reanimation departments.
Careful clinical, diagnostic, and epidemiological studies must be performed to help define the manifestations and burden of neurological disease caused by SARS-CoV-2. Precise case definitions must be used to distinguish non-specific complications of severe disease (eg, hypoxic-toxic encephalopathy and/or critical illness neuropathy) from those caused directly or indirectly by the virus, including infectious, para-infectious, and post-infectious encephalitis, hypercoagulable states leading to stroke, and acute neuropathies such as Guillain-Barré syndrome.
Although the proportion of COVID-19 infections leading to neurological disease will probably remain small, these patients might be left with life long severe neurological complications and sequelae. With large numbers of people infected, the overall number of neurological patients, and their associated health burden and social and economic costs might be large too. So, in-time detection or prophylaxis of those complications could be life-saving and economically reasonable.
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