The neurological manifestations of COVID-19 - A case series

Abstract

Severe acute respiratory syndrome (SARS) is a fatal respiratory illness caused by the coronavirus (CoV). The first known case was reported in 2002, later coined as SARS-CoV. Over the last two decades, the CoV has periodically emerged in the general population, causing a varying degree of pneumonia. The most recent outbreak, now known as coronavirus disease of 2019 (COVID-19), has been on an exponential rise. Similar to its predecessors, COVID-19 causes a fatal form of pneumonia; however, in a small percentage of patients, COVID-19 has shown to cause neurological symptoms. Given that SARS-CoV and the new CoV strain share similar viral structures, COVID-19 may have the capability to invade the neurological system. We present a series of patients with COVID-19, the first of which presented with a seizure, whereas our second patient developed seizures during their hospital course. Neither patient had a previous history of epilepsy.

Relevance for patients: COVID-19 has rapidly evolved since it was first reported and has proven to be a fatal infective process. The last several months have been challenging for the medical community as we try to understand the complexities of this virus. Clinicians have attempted to assess the most common presenting symptoms based on reported cases. The purpose of this study was to help understand how COVID-19 presents itself when the neurological system is involved. This case series describes the common and uncommon neurological manifestations of COVID-19. By doing so, we hope to provide clinicians with additional information to help diagnose COVID-19 in this unprecedented time and to also be wary of the uncommon presenting features.

Keywords: COVID-19; SARS-CoV; neurological invasion; seizures.