Fazal Rahim Wazeen , Sidra Kalsoom, Muhammad Irfan, Anum Awais, Sarfaraz Ahmad,Aftab Sharif , Saba Asif
The Severe Acute Respiratory Syndrome Coronavirus Disease-2 (SARS-CoV-2) is the causative agent of coronavirus disease-19 (COVID-19). The World Health Organization has declared this outbreak a pandemic condition, and it has become a public health emergency of international concern. Most of the population is experiencing signs and symptoms similar to the flu and common cold. Despite that, alveolar destruction resulting in progressive lung failure has also been underlined. Although SARS-CoV-2 has been underlined principally to affect the lungs, other system involvement has been described too. Neurological involvement has also been emphasized in the literature. Neurological involvement (central nervous system and peripheral nervous system) in SARS-COV-2 usually corresponds to the following situations: (a) Neurological manifestation of the acute viral infection, (b) neurological manifestations of the post-COVID-19 infection, (c) neurological image of COVID-19 in patients with comorbidities. The actual disease pathogenesis is unknown; however, direct viral invasion of neuronal cells, followed by significant inflammation due to cytokine and inflammatory markers, activation of the complement system, and hypoxia resulting from viral-mediated lung injury leading to oxidative stress, and neuronal cell injury are the proposed mechanisms. Patients with neurological involvement usually experience a wide range of signs and symptoms such as headache, nausea, drowsiness, seizures, altered sensorium, vomiting, and hyposmia. The pandemic of SARS-CoV-2 has become an unprecedented challenge for the physicians and neurologists. Various neurological manifestations have been observed and reported in many cases, and neurological symptoms may precede classical respiratory signs and symptoms. This review summarized the data from published literature, including case reports and open-source data sets to describe the spectrum of neurological manifestations and complications observed in COVID-19 cases.