COVID-19 and the brain

Entering the third year into the pandemic, overwhelming evidence demonstrates that Coronavirus disease 2019 (COVID-19) infection is a systemic illness, often with involvement of the central nervous system. Multiple mechanisms may underlie the development of neurologic manifestations of illness, including hypoxia, systemic illness, hypercoagulability, endothelial dysfunction, general critical illness, inflammatory response, and neurotropism of the severe acute respiratory syndrome coronavirus 2 (SARS-Co-V2) virus. COVID-19 infection is associated with neurologic involvement in all stages; acute infection, subacute/post-infection, and growing evidence also suggests during a chronic phase, the post-acute sequalae of COVID-19 (PASC). With over 20,000 published articles on COVID and the brain at the time of writing, it is virtually impossible to present an unbiased comprehensive review of how SARS-Co-V2 impacts the nervous system. In this review, we will present an overview of common neurologic manifestations, in particular focusing on the cerebrovascular complications, and proposed pathophysiology. (c) 2022 Elsevier Inc. All rights reserved.

Automated summary

Entering the third year of the pandemic, there is overwhelming evidence showing that COVID-19 infection is a systemic illness that often affects the central nervous system. Neurologic involvement has been observed in all stages of the infection, including acute infection, subacute/post-infection, and the post-acute sequalae of COVID-19 (PASC). Due to the large number of published articles on COVID-19 and the brain, it is almost impossible to provide an unbiased comprehensive review on how the SARS-Co-V2 virus impacts the nervous system. This review provides an overview of common neurologic manifestations, with a particular focus on cerebrovascular complications and proposed pathophysiology.