• How can COVID-19 affect the nervous system?: A comprehensive review study
  • Mina AkbariRad,1,*
    1. Assistant Professor of Internal Medicine, Department of Internal Medicine, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.


  • Introduction: Today the novel coronavirus disease (COVID-19) becomes a great disaster all over the world. According to the current knowledge, this virus can cause some molecular processes which lead to neuroinflammation, neurodegeneration, and neuronal injury. In this study, we briefly reviewed these possible molecular processes and the clinical neurological manifestations of the COVID-19.
  • Methods: A comprehensive search was done through electronic databases including PubMed, Embase, Scopus, and Web of Sciences with the related MeSh terms. Original and review studies, which studied on adults, were included, also the references of the review studies were rechecked to reduces the risk of bias and missing any related article. Due to the possible effects of interventions, randomized clinical trial studies were excluded from the final review.
  • Results: According to the cytokine storm and immune responses caused by COVID-19, different injuries and damages are predictable. An increase in IL-6, TNF-α, and activation of mast cells can lead to inflammation, especially neuroinflammatory processes. The clinical manifestations of these processes are evaluated by several studies that determined more frequent neurologic disorders in moderate and severe infected patients. Although confusion was observed too frequently in COVID-19 patients, other neurological manifestations such as dizziness, anosmia, visional problems, ataxia, and cerebrovascular diseases were observed in some cases persistently. It is important to note that there have not been found any significant differences between infected patients and non-infected ones in terms of their brain MRIs.
  • Conclusion: Based on the novelty of the current infectious disease, there is little knowledge about its mechanisms and clinical manifestations, especially about the nervous system. However, more studies are needed to clarify the exact effects of the COVID-19 on the nervous system, but it is certain that this virus potentially has destructive effects on our nervous system.
  • Keywords: COVID-19, Neuroinflammation, Neurodegeneration, Neurological manifestations