COVID and nervous system: Mechanisms and consequences

This chapter explores the intricate relationship between COVID-19 and the nervous system. The neurological disorders associated with COVID-19 infection, collectively referred to as “Neuro-COVID,” are among the most alarming, controversial, and least understood aspects of the recent pandemic. Since the emergence of the SARS-CoV-2 virus, indeed, mounting evidence has suggested that this coronavirus can significantly impact the nervous system, leading to a broad spectrum of neurological manifestations and consequences. Therefore, this chapter delves into the mechanisms underlying the neurological involvement of COVID-19. It begins by elucidating the potential pathways through which the virus can gain access to the central nervous system, including the possible routes of invasion and viral dissemination. The discussion then shifts to the complex interplay between the virus and the immune system, shedding light on the role of cytokine storms and neuroinflammation in promoting neurological damage. Additionally, the impact of COVID-19 on the blood-brain barrier and its implications for neurological complications are examined in detail. The second part of the chapter addresses clinical manifestations. The Neuro-COVID spectrum encompasses a wide array of symptoms and clinical manifestations, such as anosmia, ageusia, acute encephalopathy, cerebrovascular events, Guillain-Barré syndrome, and more. The possible long-term consequences of the disease on the nervous system are also discussed. Finally, an ongoing concern is the potential increased risk of neurologically related disorders years after the initial infection. To address these uncertainties, dedicated epidemiological studies are crucial for gaining clarity and a deeper understanding of this issue.