Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Review Article Volume 4 Issue 2

Brain Disorders at Admission, During and After SARS-CoV-2 Infection

Magda Tsolaki*, Antonios Frontistis, Paschalis Devranis, Maria Zilakaki, Iordanis Saoulidis, Vasileios Siokas, Ioannis Papagiannis, Eleni Liouta, Evagelos Papatolis, Evripidis Pityrigkas, Vasiliki Poulidou, Evangelia Chartampila, Sofia Pettemeridou, Hadar Halivni, Cindy Cheng, Thomas Tegos

Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Makedonia, Greece

*Corresponding Author: Magda Tsolaki, Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Makedonia, Greece.

Received: September 28, 2020; Published: October 22, 2020



  The potential involvement of SARS-CoV-2 in Central Nervous System (CNS) has attracted considerable attention because of the neurological and psychiatric manifestations presented throughout the disease process. There have been many reports of extra respiratory manifestations, such as neurological and psychiatric symptoms at the admission of the patients in the Hospitals, during and after SARS-CoV-2 infection. The seriousness of the virus in various parts of the body will determine what comes after the initial phase. The main brain symptoms and brain disorders that are described in many studies at admission during and after infection are: impaired memory (34,1%), dizziness (7,9 - 16,8%), headache (3,7 - 90,5%), stroke (2,8 - 8,1%) (cerebral infarction (1,6%), venous thrombosis, intracerebral, or subarachnoid hemorrhage), meningitis/encephalitis, and acute necrotizing hemorrhagic encephalopathy, impaired consciousness (7,5 - 7,8%), seizures (1-1,5%), loss of sense of smell (hyposmia (14,5% - 35,6%---34%)) or taste (hypogeusia (12,5%---34%), depressive symptoms (35%), depression (47,1% - 14,9), suicidality (2%), delirium/confusion (27,0%-27,9%), insomnia (41,9%---12,1%---100%), anxiety (35,7%---14,8%), somatization (45,9%), psychosis (3,9---4,4), and post-traumatic stress disorder (96,2% - 32,2%). Unfortunately, all these percentages are changing every day and perhaps we’ll have the reliable numbers at the end of the COVID-19 pandemic, which we wish to be very soon.

Keywords: Covid 19; Brain Disorders; Neurological and Psychiatric



  1. Tsivgoulis G., et al. “Neurological manifestations and implications of COVID-19 pandemic. Version 2”. Therapeutic Advances in Neurological Disorders 13 (2020): 1756286420932036.
  2. Mao L., et al. “Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China”. JAMA Neurology6 (2020): 683.
  3. Köhler-Forsberg O., et al. “Efficacy of anti-inflammatory treatment on major depressive disorder or depressive symptoms: meta-analysis of clinical trials”. Acta Psychiatrica Scandinavica 5 (2019): 404-419.
  4. Bostanciklioglu M. “Severe acute respiratory syndrome coronavirus 2 is penetrating to dementia research”. Current Neurovascular Research (2020).
  5. Zhou Z., et al. “Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms”. Journal of Neurology 26 (2020): 1-6.
  6. Chen T., et al. “Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study”. BMJ 368 (2020): m1091.
  7. Ge J and Barnes NM. “Alterations in angiotensin AT1 and AT2 receptor subtype levels in brain regions from patients with neurodegenerative disorders”. European Journal of Pharmacology3 (1996): 299-306.
  8. Yin C., et al. “Clinical analysis of multiple organ dysfunction syndrome in patients suffering from SARS”. Zhongguo weizhong bing ji jiu yi xue= Chinese critical care medicine= Zhongguo weizhongbing ‘jijiuyixue11 (2004): 646-650.
  9. Merkler AE., et al. “Risk of Ischemic Stroke in Patients With Coronavirus Disease 2019 (COVID-19) vs Patients With Influenza”. JAMA Neurology (2020).
  10. Zhao H., et al. “Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence?”. Lancet Neurology5 (2020): 383-384.
  11. Klok F., et al. “Incidence of thrombotic complications in critically ill ICU patients with COVID-19”. Thrombosis Research 191 (2020): 145-147.
  12. Kristoffersen ES., et al. “Effect of Covid-19 pandemic on stroke admission rates in a Norwegian population”. Acta Neurologica Scandinavica 2020).
  13. Zoghi A., et al. “A case of possible atypical demyelinating event of the central nervous system following COVID-19”. Multiple Sclerosis and Related Disorders 44 (2020): 102324.
  14. Ferrara F., et al. “Worldwide Recommendations and Therapies for Multiple Sclerosis: Are They Safe in the COVID-19 Pandemic Period?” SN Comprehensive Clinical Medicine 26 (2020): 1-2.
  15. Paterson RW., et al. “UCL Queen Square National Hospital for Neurology and Neurosurgery COVID-19 Study Group. The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings”. Brain (2020): awaa240.
  16. Argenziano MG., et al. “Characterization and clinical course of 1000 Patients with COVID-19 in New York: retrospective case series”. medRxiv (2020).
  17. Mi B., et al. “Characteristics and Early Prognosis of COVID-19 Infection in Fracture Patients”. Journal of Bone and Joint Surgery 9 (2020): 750-758.
  18. Du N., et al. “A case series describing the epidemiology and clinical characteristics of COVID-19 infection in Jilin Province”. Virulence1 (2020): 482-485.
  19. Gupta N., et al. “Clinical and epidemiologic profile of the initial COVID-19 patients at a tertiary care centre in India”. Monaldi Archives for Chest Disease1 (2020).
  20. Zhong ZF., et al. “Epidemiological and clinical characteristics of COVID-19 patients in Hengyang, Hunan Province, China”. World Journal of Clinical Cases 12 (2020): 2554-2565.
  21. Yang X., et al. “Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: A single-centered, retrospective, observational study”. The Lancet Respiratory Medicine5 (2020): 475-481.
  22. Luo Y., et al. “Investigation of COVID-19-related symptoms based on factor analysis”. Annals of Palliative Medicine4 (2020): 1851-1858.
  23. Xu XW., et al. “Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series”. BMJ (2020): m606.
  24. Kremer S., et al. “Neurologic and neuroimaging findings in COVID-19 patients: A retrospective multicenter study”. Neurology (2020).
  25. Ghweil A A., et al. “Characteristics, Outcomes and Indicators of Severity for COVID-19 Among Sample of ESNA Quarantine Hospital’s Patients, Egypt: A Retrospective Study”. Infection and Drug Resistance 13 (2020): 2375-2383.
  26. Zayet S., et al. “Clinical features of COVID-19 and influenza: a comparative study on Nord Franche-Comte cluster”. Microbes and Infection (2020).
  27. Shi H., et al. “Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: A descriptive study”. The Lancet Infectious Diseases4 (2020): 425-434.
  28. Tostmann A., et al. “Strong associations and moderate predictive value of early symptoms for SARS-CoV-2 test positivity among healthcare workers, the Netherlands, March 2020”. Eurosurveillance 16 (2020).
  29. Chen N., et al. “Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study”. The Lancet10223 (2020): 507-513.
  30. Koh J., et al. “Epidemiological and Clinical Characteristics of Cases During the Early Phase of COVID-19 Pandemic: A Systematic Review and Meta-Analysis”. Frontiers in Medicine 7 (2020).
  31. Zhang X., et al. “Epidemiological, clinical characteristics of cases of SARS-CoV-2 infection with abnormal imaging findings”. International Journal of Infectious Diseases 94 (2020): 81-87.
  32. Jin X., et al. “Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms”. Gut6 (2020): 1002-1009.
  33. Li J., et al. “Identification of Symptoms Prognostic of COVID-19 Severity: Multivariate Data Analysis of a Case Series in Henan Province”. Journal of Medical Internet Research6 (2020).
  34. Lian JS., et al. “Comparison of epidemiological and clinical characteristics of COVID-19 patients with and without Wuhan exposure”. Journal of Zhejiang University-SCIENCE B5 (2020): 369-377.
  35. Romero-Sánchez C M., et al. “Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry”. Neurology (2020).
  36. Guan W., et al. “Clinical Characteristics of Coronavirus Disease 2019 in China’. New England Journal of Medicine18 (2020): 1708-1720.
  37. Li L., et al. “COVID‐19 patients' clinical characteristics, discharge rate, and fatality rate of meta‐analysis”. Journal of Medical Virology6 (2020): 577-583.
  38. Lechien J R., et al. “Clinical and epidemiological characteristics of 1420 European patients with mild‐to‐moderate coronavirus disease 2019”. Journal of Internal Medicine3 (2020): 335-344.
  39. Lapostolle F., et al. “Clinical features of 1487 COVID-19 patients with outpatient management in the Greater Paris: the COVID-call study”. Internal and Emergency Medicine5 (2020): 813-817.
  40. Moro E., et al. “The international European Academy of Neurology survey on neurological symptoms in patients with COVID‐19 infection”. European Journal of Neurology9 (2020): 1727-1737.
  41. Zhu J., et al. “Clinical characteristics of 3062 COVID‐19 patients: A meta‐analysis”. Journal of Medical Virology (2020).
  42. Kumar A., et al. “Clinical Features of COVID-19 and Factors Associated with Severe Clinical Course: A Systematic Review and Meta-Analysis”. SSRN Electronic Journal (2020).
  43. Pinzon R T., et al. “Neurologic Characteristics in Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis”. Frontiers in Neurology (2020): 11.
  44. Zhu J., et al. “Clinicopathological characteristics of 8697 patients with COVID-19 in China: a meta-analysis”. Family Medicine and Community Health2 (2020).
  45. Abdullahi A., et al. “Neurological and Musculoskeletal Features of COVID-19: A Systematic Review and Meta-Analysis”. Frontiers in Neurology (2020): 11.
  46. Chen X., et al. “A systematic review of neurological symptoms and complications of COVID-19”. Journal of Neurology (2020).
  47. Nascimento I J., et al. “Novel Coronavirus Infection (COVID-19) in Humans: A Scoping Review and Meta-Analysis”. Journal of Clinical Medicine4 (2020): 941.
  48. Nepal G., et al. “Neurological manifestations of COVID-19: a systematic review”. Critical Care1 (2020).
  49. Chen N., et al. “Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study”. Lancet10223 (2020): 507-513.
  50. Mardani M., et al. “COVID-19 infection recurrence presenting with meningoencephalitis”. New Microbes and New Infection 37 (2020): 100732.
  51. Duong L., et al. “Meningoencephalitis without respiratory failure in a young female patient with COVID-19 infection in Downtown Los Angeles, early April 2020”. Brain, Behavior, and Immunity 87 (2020): 33.
  52. Ye M., et al. “Encephalitis as a clinical manifestation of COVID-19. Brain, Behavior, and Immunity 88 (2020): 945-946.
  53. Ghannam M., et al. “Neurological involvement of coronavirus disease 2019: a systematic review”. Journal of Neurology (2020).
  54. Sureda A., et al. “Endoplasmic reticulum as a potential therapeutic target for covid-19 infection management?” European Journal of Pharmacology 882 (2020): 173288.
  55. Ding Y., et al. “Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways”. Journal of Pathology2 (2004): 622-630.
  56. Azevedo FAC., et al. “Equal numbers of neuronal and nonneuronal cells make the human brain an isometrically scaled-up primate brain”. Journal of Compressive Neurology5 (2009): 532-541.
  57. Bulfamante G., et al. “First ultrastructural autoptic findings of SARS -Cov-2 in olfactory pathways and brainstem”. Minerva Anesthesiology6 (2020): 678-679.
  58. Li K., et al. “Middle East Respiratory Syndrome Coronavirus Causes Multiple Organ Damage and Lethal Disease in Mice Transgenic for Human Dipeptidyl Peptidase 4”. Journal of Infection Disease5 (2016): 712-722.
  59. Whittaker A., et al. “Neurological Manifestations of COVID‐19: A systematic review and current update”. Acta Neurologica Scandinavica1 (2020): 14-22.
  60. Lu L., et al. “New onset acute symptomatic seizure and risk factors in coronavirus disease 2019: A retrospective multicenter study”. Epilepsia6 (2020).
  61. Vollono C., et al. “Focal status epilepticus as unique clinical feature of COVID-19: A case report”. Seizure 78 (2020): 109-112.
  62. Ibrahim E Efe., et al. “COVID-19−Associated Encephalitis Mimicking Glial Tumor”. World Neurosurgery 140 (2020): 46-48.
  63. Hepburn M., et al. “Acute Symptomatic Seizures in Critically Ill Patients with COVID-19: Is There an Association?” Neurocritical Care 28 (2020): 1-5.
  64. Costello F and Dalakas MC. “Cranial neuropathies and COVID-19: Neurotropism and autoimmunity 95.5 (2020): 195-196.
  65. Sani G., et al. “Mental health during and after the COVID-19 emergency in Italy”. Psychiatry Clinical Neuroscience (2020).
  66. Ran L., et al. “Psychological resilience, depression, anxiety, and somatization symptoms in response to COVID-19: A study of the general population in China at the peak of its epidemic”. Social Science and Medicine 262 (2020): 113261.
  67. Shigemura J., et al. “Public responses to the novel 2019 coronavirus (2019-nCoV) in Japan: Mental health consequences and target populations”. Psychiatry and Clinical Neurosciences 74 (2020): 281-282.
  68. Sher L. “COVID-19, anxiety, sleep disturbances and suicide”. Sleep Medicine 70 (2020): 124.
  69. Huang Y and Zhao N. “Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey”. Psychiatry Research 288 (2020): 112954.
  70. Brief Psychotic Disorder during the national lockdown in Italy: an emerging clinical phenomenon of the coronavirus pandemic | Schizophrenia Bulletin | Oxford Academic.
  71. Carfì A., et al. “Persistent Symptoms in Patients After Acute COVID-19”. JAMA 6 (2020): 603-605.


Citation: Magda Tsolaki., et al. “Brain Disorders at Admission, During and After SARS-CoV-2 Infection". Acta Scientific Neurology 4.2 (2021): 37-50.


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