Table 1.
Main characteristics of the selected studies.
| Author and Year | Study Location | Objective | Methodology | Results | Conclusion |
|---|---|---|---|---|---|
| Arabi et al. (2015) | Saudi Arabia | To observe the association between three cases with neurological symptoms in patients with MERS-CoV. | Retrospective data collection in three cases admitted to the ICU in King Abdulaziz Medical City, Riyadh with MERS-CoV. | The patients presented severe neurological syndrome, characterized by altered consciousness, ataxia, and focal motor deficit. Brain MRI revealed striking changes. | Involvement of the CNS should be considered in patients with MERS-CoV and progressive neurological disease; it is necessary to elucidate the pathophysiology further. |
| Li et al. (2017) | China | To explore cytokine expression profiles of children hospitalized with CoV-CNS and CoV-respiratory infections. | The authors collected and analyzed clinical and laboratory data of 183 children hospitalized with clinical suspicion of acute encephalitis and 236 children with acute respiratory tract infection in Hunan, China. | A fraction of the sample with acute encephalitis was identified with CoV infection. Patients with CoV-CNS infection presented a different cytokine profile than those with CoV-respiratory infection. | CoV-CNS infection may be common and express multiple cytokines with possible immune impairment of the nervous system. |
| Kim et al. (2017) | South Korea | To evaluate neurological manifestations in patients with MERS-CoV. | Retrospective analysis of clinical, laboratory, and imaging records of 23 patients with MERS-CoV in South Korea. | Four patients were found to have neurological complications during treatment for MERS. The most probably diagnoses were GBS, BBE, ICU-acquired weakness, or other toxic or infectious neuropathy. | Neurological complications exist in MERS-CoV. They are not rare, and they interfere with prognosis and may require adequate treatment. |
| Mao et al. (2020) | China | To study neurological manifestations of patients hospitalized with COVID-19. | Retrospective study through review of clinical records and laboratory and imaging exams of 214 patients with COVID-19 in Wuhan, China. | A number of patients had neurological manifestations in the central or peripheral nervous system or proven skeletal muscular injuries. | SARS-CoV-2 may infect the nervous system and lead to neurological manifestations, especially in severe cases. |
| Chen et al. (2020) | China | To describe the clinical characteristics of patients who died of COVID-19. | Retrospective case series through study of clinical, laboratory, and imaging data of 113 patients who died of COVID-19 in Wuhan, China. | Hypoxic encephalopathy was a common complication in patients who died, showing a potential association with clinical outcome. | The development of neurological complications is strongly associated with negative results in patients with COVID-19. |
| Moriguchi et al. (2020) | Japan | To report a case of neurological involvement associated with SARS-CoV-2. | Clinical analysis of the case, report of symptoms, and specimen collection testing for SARS-CoV-2 were conducted. | Magnetic resonance showed abnormal findings in the medial temporal lobe, including the hippocampus, suggesting encephalitis, hippocampal sclerosis, or post-convulsive encephalitis. | The study indicated the neuroinvasive potential of the virus, as well as its presence even when nasopharyngeal sample tests negative. |
| Poyiadji et al. (2020), | United States of America | To report the first presumed case of acute necrotizing hemorrhagic encephalopathy associated with COVID-19. | Diagnosis of SARS-CoV-2 was made by real-time reverse transcriptase-PCR assay. The authors analyzed CSF, as well as CT and MRI. | Noncontrast head CT demonstrated symmetric hypoattenuation in thalamic regions. Brain MRI demonstrated lesions that enhanced the hemorrhagic rim. | To the extent that the number of cases of COVID-19 increases around the world, clinical physicians and radiologists should be aware of this presentation among patients who present COVID-19 and altered mental status. |
Legends: BBE: Bickerstaff’s encephalitis, GBS: Guillain-Barré syndrome, ICU: Intensive Care Unit.