Table 3.
CNS Complications Reported During and After SARS-CoV-2 Infection.
| No. |
Neurological Symptom |
Ref. No. | No. of patients | Mean Age of the patients(Range) | Notes |
|---|---|---|---|---|---|
| Headache and dizziness | |||||
| 1 | Headache 34 Articles |
[38] [39] [40], [41], [42], [43], [44], [45], [46], [47], [48], [49],. [50], [51], [52], [53], [54], [55], 56), [57], [58], [59], [60] [61],[62], [63] [64] [65] [66], [67], [68], [69] [70], [178] | 2073 | NR in all articles. | |
| 2 | Dizziness 11 Articles |
[39], [43], [47], [48], [57], [60], [62], [69], [70], [71], [72] | 173 | NR in all articles. | Kong Z et al. [72]reported a 53 Y/O F with dizziness as the first presentation of COVID-19. |
| Cerebrovascular events | |||||
| 3 | Ischemic Stroke 37 Articles |
[39], [57], [58], [60], [63], [73], [74], [75], [76] [77], [78], [79], [80],. [81], [82], [83], [84], [85], [86], [87], [88], [89], [90], [91], [92], [93], [94], [95], [96], [97], [98], [99], [100], [101], [102], [178], [192] | 363 | NR in all articles. | In large population studies ischemic stroke was reported in 1% [77] to 2.5% [84] of patients. Young adult patients without any past medical history [80] and patients with large-vessel stroke were reported. [80,85,95] One 38 Y/O F patient with stroke and CADASIL was reported. [89] A 67 Y/O M simultaneous cerebral infarcts in multiple arterial territories were reported. [91] |
| 4 | TIA 3 Articles |
[58], [75], [94] | 7 | NR in all articles. | |
| 5 | Cerebral Hemorrhage 19 Articles |
[39], [57], [58], [60], [63], [75] [86]), [92], [98], [99], [100], [101], [106], [107], [108], [109], [110], [111], [112], | 61 | NR in all articles. | Muhammad S et al. [107] reported a 60 Y/O F with aneurysm and ICH. Ghosh R, et al. [111], reported a 19 Y/O F with Moyamoya Angiopathy and ICH. |
|
6 |
Cerebral Venous Sinus Thrombosis 9 Articles |
[99], [101], [102], [114], [115], [116], [117], [118], [192] | 13 | NR in all articles. | Malentacchi M et al. [102] reported 81 Y/O M with both arterial and venous thrombosis. |
| Acute demyelination | |||||
| 7 | Acute disseminated encephalomyelitis (ADEM) 4 Articles |
[120], [121], [122], [123] | 4 2M 2F |
61(51–71) | Reichard RR et al. [122], study reported post-mortem examinations of a 71 Y/O M which revealed ADEM-like appearance at the brain biopsy. |
| 8 | Acute Myelitis 5 Articles |
[125], [126], [127], [128], [129] | 5 3M 2F |
55.6(22–69) | In one of these patients [125] CSF or MRI exam was not performed. Sotoca J et al. [127], reported 69 y/o F acute necrotizing myelitis. Giorgianni A, et al. [128] reported a 22 Y/O F with transient acute-onset tetra paresis with normal MRI and CSF exam. |
| 9 | Optic Neuritis 1 Article |
[60] | 1 | NR | |
| 10 | Acute encephalomyelitis 4 Articles |
[132], 179) [187] [196] | 4 2M 2F |
21-54 | Zoghi A et al. [132], reported 21 Y/O M suspicious to ADEM or neuromyelitis-optica spectrum disorder. Zanin L, et al. [179] reported a 54 Y/O F with seizure and brain and spine demyelinating lesions. Brun G et al. [187] reported a 54 Y/O F with Multiple supra-tentorial punctiform and tumefactive lesions involving the white matter bilaterally. Demirci Otluoglu G et al. [196] reported a 48 Y/O M with Acute encephalomyelitis and positive CSF for SARS-CoV2 |
| Impaired consciousness, encephalopathy and encephalitis | |||||
|
11 |
Decreased level of consciousness And Encephalopathy 22 Articles |
[39], [40], [57], [58] [60], [62] [88], [96], [98], [100], [101], [133], [135], [136] [137], [138], [139] [140], [141] [178] [184] [189] [195] [197] | 4,54 | NR in all articles. | Yin R et al. [133] reported a 64 Y/O M with altered consciousness and Psychiatric symptoms, his brain CT scan was Normal. Farhadian S et al. [138], reported a 78 Y/O F with acute encephalopathy and elevated CSF inflammatory markers. Hosseini AA et al. [139], reported 2 patients (46 Y/O, 79 Y/O) F with Delirium as a presenting feature in COVID-19, neuro-invasion or autoimmune encephalopathy was suggested as the cause. Kulick-Soper CV, et al. [189] reported a 54 Y/O F with bilateral globus pallidus lesions and possibility of hypoxic brain damage. |
|
12 |
Leukoencephalopathy 3Articles |
[144], [145] [188] | 18 | NR in all articles. | Radmanesh A et al. [145] reported 4 patients with leukoencephalopathy one patient with micro-hemorrhages and six patients with both presentations. |
| 13 | Acute Necrotizing Encephalopathy(ANE) 6 Articles |
[146] [147], [148], [149] [178] [193] | 8 | NR in all articles. | Virhammar J, et al. [146], reported 55 Y/O F with ANE with abnormal CSF. Radmanesh A et al. [147], reported 50 Y/O M delayed post-hypoxic necrotizing leukoencephalopathy. Dixon L et al. [149] reported ANE in a 59 Y/O F with history of aplastic anemia who died despite steroid therapy. |
|
14 |
Encephalitis 13 Articles |
[60], [98], [100], [150], [151], [151], [152], [153], [154], [155], [156], [157], [158] | 22 | NR in all articles. | Wong PF et al. [151], reported a 40 Y/O M Rhombencephalitis. Pilotto A et a.l [152], a 60 y/o patient with steroid responsive encephalitis. Efe IE et al. [157], reported a 35 Y/O F with encephalitis mimicking glial tumor. |
| 15 | Mild encephalitis/encephalopathy with a Reversible Splenial Lesion(MERS) 1 Article |
[160] | 1 M |
75 | |
|
16 |
Posterior reversible encephalopathy syndrome (PRES). 8 Articles |
[58], [101], [161], [162], [163] [164],[165], [190] | 10 | NR in all articles. | Franceschi AM et al. [161], reported 2 patients with hemorrhagic PRES. Kaya Y et al. [162], reported a 38 M with cortical blindness PRES like syndrome. Coolen T et al. [190]performed early postmortem brain MRI in patients who died from COVID-19 complications. |
| Seizure | |||||
|
17 |
Seizure 20 Articles |
[39], [58], [60], [63], [101], [150], [166], [167], [168], [169], [170], [171], [172], [173], [174], [175] [176] [177], [178], [179] | 48 | NR in all articles. | Somani S et al. [166], Balloy G, et al. [167] and), Le Guennec L et al. [172] reported 4 patients with status epilepticus. Logmin K et al. [171], reported a 70 Y/O patient with non-epileptic seizures. Elgamasy S et al. [174] reported 73 Y/O F with focal epilepsy. Vollono C et al. [175]reported a case of focal status epilepticus from left fronto-centro-temporal area(MRI showed extensive gliosis and atrophy at that site due to previous herpes encephalitis.) Scullen T et al. [178],reported a case of non-convulsive status epilepticus. |
| Movement disorders | |||||
| 18 | Generalized Myoclonus, Hypokinetic-rigid syndrome 2 Articles |
[182], [183] | 4 3M 1F |
71.25(58–88) | |
| CNS Vasculitis | |||||
| 19 | CNS Vasculitis 2 Articles |
[98] [185], | 2 | NR in all articles. | |
| Cranial Nerve abnormalities | |||||
| 20 | Anosmia 28 Articles |
[39], [56], [57], [58], [62], [69], [101], [182], [183], [198], [199], [200], [201], [202], [203], [204], [205], [206], [61], [207], [208], [209], [210], [211], [212], [213] [214], |
3730 | NR in all articles. | Mermelstein S [202] a 27 Y/O neurology registrar, reported her symptoms and anosmia after COVID-19. |
| 21 | Ageusia 14 Articles |
[39], [56], [57], [58], [61], [62], [69], [200], [201] [203] [204], [205], [206], [214] | 2590 | NR in all articles. | |
| 22 | Impaired Vision 3 Articles |
[39], [57], [204] | 12 | NR in all articles. | |
Abbreviation: M: Male, F: Female, NR: Not reported.