Neurological implications of COVID-19: a review of the science and clinical guidance

doi:10.1136/bmjno-2020-000101

Review

. 2020 Dec 14;2(2):e000101.

doi: 10.1136/bmjno-2020-000101. eCollection 2020.

Neurological implications of COVID-19: a review of the science and clinical guidance

Lynn Tan¹, Zhiliang Caleb Lin², Jason Ray^{1

3}, Robb Wesselingh^{1

3}, Thomas J Oxley^{4

5}, James McFadyen^{6

7

8}, Mahima Kapoor^{1

3}, Elspeth Hutton^{1

3}

Affiliations

¹ Neurology Department, Alfred Hospital, Melbourne, Victoria, Australia.
² Monash Emergency, Monash University School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia.
³ Neuroscience Department, Monash University Central Clinical School, Melbourne, Victoria, Australia.
⁴ Cerebrovascular Centre, Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA.
⁵ Vascular Bionics Laboratory, Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
⁶ Haematology Department, Alfred Hospital, Melbourne, Victoria, Australia.
⁷ Department of Medicine, Monash University, Clayton, Victoria, Australia.
⁸ Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.

PMID: 33681805
PMCID: PMC7871721
DOI: 10.1136/bmjno-2020-000101

Review

Neurological implications of COVID-19: a review of the science and clinical guidance

Lynn Tan et al. BMJ Neurol Open. 2020.

. 2020 Dec 14;2(2):e000101.

doi: 10.1136/bmjno-2020-000101. eCollection 2020.

Authors

Lynn Tan¹, Zhiliang Caleb Lin², Jason Ray^{1

3}, Robb Wesselingh^{1

3}, Thomas J Oxley^{4

5}, James McFadyen^{6

7

8}, Mahima Kapoor^{1

3}, Elspeth Hutton^{1

3}

Affiliations

¹ Neurology Department, Alfred Hospital, Melbourne, Victoria, Australia.
² Monash Emergency, Monash University School of Clinical Sciences at Monash Health, Clayton, Victoria, Australia.
³ Neuroscience Department, Monash University Central Clinical School, Melbourne, Victoria, Australia.
⁴ Cerebrovascular Centre, Department of Neurosurgery, Mount Sinai Hospital, New York, New York, USA.
⁵ Vascular Bionics Laboratory, Department of Medicine, University of Melbourne, Melbourne, Victoria, Australia.
⁶ Haematology Department, Alfred Hospital, Melbourne, Victoria, Australia.
⁷ Department of Medicine, Monash University, Clayton, Victoria, Australia.
⁸ Atherothrombosis and Vascular Biology Program, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.

PMID: 33681805
PMCID: PMC7871721
DOI: 10.1136/bmjno-2020-000101

Abstract

COVID-19 is a significant global health burden. The pulmonary morbidity and mortality of COVID-19 is well described, however, there is mounting evidence of neurological manifestations of SARS-CoV-2, which may be of prognostic significance. This paper summarises the available evidence in order to provide clinicians with a concise summary of the peripheral and central neurological manifestations of COVID-19, discusses specific issues regarding the management of chronic neurological disease in the context of the pandemic, and provides a summary of the thrombotic implications of the disease for the neurologist.

Keywords: clinical neurology; stroke.

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Conflict of interest statement

Competing interests: None declared.

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References

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[1] Dodds K, Broto VC, Detterbeck K, et al. . The COVID-19 pandemic: territorial, political and governance dimensions of the crisis. Territ Politic Gov 2020;8:289–98. 10.1080/21622671.2020.1771022 - DOI

[2] Dodds K, Broto VC, Detterbeck K, et al. . The COVID-19 pandemic: territorial, political and governance dimensions of the crisis. Territ Politic Gov 2020;8:289–98. 10.1080/21622671.2020.1771022 - DOI

[3] Australian Government Department of Health Coronavirus (COVID-19) current situation and case numbers Australia: Australian government department of health, 2020. Available: https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov... [Accessed 25 Oct 2020].

[4] Australian Government Department of Health Coronavirus (COVID-19) current situation and case numbers Australia: Australian government department of health, 2020. Available: https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov... [Accessed 25 Oct 2020].

[5] Worldometer COVID-19 coronavirus pandemic: coronavirus cases, 2020. Available: https://www.worldometers.info/coronavirus/ [Accessed 25 Oct 2020].

[6] Worldometer COVID-19 coronavirus pandemic: coronavirus cases, 2020. Available: https://www.worldometers.info/coronavirus/ [Accessed 25 Oct 2020].

[7] Ellul MA, Benjamin L, Singh B, et al. . Neurological associations of COVID-19. Lancet Neurol 2020. - PMC - PubMed

[8] Ellul MA, Benjamin L, Singh B, et al. . Neurological associations of COVID-19. Lancet Neurol 2020. - PMC - PubMed

[9] Garg RK, Paliwal VK, Gupta A. Encephalopathy in patients with COVID‐19: a review. J Med Virol 2020;0140 10.1002/jmv.26207 - DOI - PubMed

[10] Garg RK, Paliwal VK, Gupta A. Encephalopathy in patients with COVID‐19: a review. J Med Virol 2020;0140 10.1002/jmv.26207 - DOI - PubMed

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Neurological implications of COVID-19: a review of the science and clinical guidance

Affiliations

Neurological implications of COVID-19: a review of the science and clinical guidance

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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