Neurological complications associated with COVID-19: Systematic review of evidence on manifestations, complications, and pathological mechanisms

Abstract

Objective: To analyze the complex synergistic interaction between Covid-19 and the neurological manifestations caused by the infection, exploring the clinical, epidemiological and pathophysiological implications. It also seeks to evaluate the diagnostic challenges faced by patients and discuss public health strategies. Methodology: It is a systematic review focused on understanding the main aspects of Covid-19 co-infection and neurological symptoms. The research was guided by the question: 'What are the biological and immunological mechanisms underlying the interaction between SARS-CoV-2 and the development of neurological complications and how do they affect susceptibility, disease progression and the clinical manifestations of patients?' To find answers, we searched the PubMed database using four descriptors combined with the Boolean term "AND": Guillain-Barre Syndrome, COVID-19, SARS-CoV-2, and COVID-19 Vaccines. This resulted in 562 articles. 19 articles were selected for analysis. Results: It is evident that the neurological involvement associated with COVID-19 covers a wide variety of manifestations, from milder symptoms, such as headache and smell and taste disorders, to more severe complications, such as encephalopathy, encephalitis, seizures, and strokes. These manifestations appear to be influenced by mechanisms such as systemic inflammation, hypoxia, direct viral invasion of the central nervous system (CNS), and exaggerated immune responses, which can result in irreversible damage to nervous tissue. Conclusion: The review highlights the importance of early diagnosis and close clinical monitoring to improve outcomes.