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Document Type

Review Article

Abstract

Severe acute respiratory syndrome corona virus 2 (SARS CoV 2) seems to display an increasing affinity for the nervous system. The ongoing pandemic has made evident that diverse neurological manifestations may occur with COVID 19. Headache and dizziness remain the most common symptoms however stroke, seizures, encephalopathy, neuropathy and skeletal muscle injury may be seen. An increasing number of patients report initial anosmia and ageusia. Tendency for serious illness is believed to be in the elderly or people with a history of diabetes, high blood pressure and heart disease. Many patients on immunosuppressive therapies such as multiple sclerosis, myasthenia gravis or sarcoidosis are additionally high risk. Angiotensin-converting enzyme 2 (ACE 2) has been identified as the cellular receptor for SARS CoV 2 present in both neurons and glial tissue. The pathophysiology of neurotoxicity at best remains elusive with dysregulation of homeostasis and pro inflammatory cytokine production causing direct, indirect and post infectious neurological complications. Vigilant observation for neurological involvement is important not only to prevent spread of this highly contagious disease but also for appropriate, timely management. A directed neurological examination limiting exposure of medical personnel to potentially infected patients is mandatory. Appropriate constrained investigations should be considered only if there is a likelihood of changing management. Tele neurology consultations, whenever possible is the need of the hour. Outcomes of COVID 19 patients with severe illness and neurological complications remains grave. Pharmaceutical research needs to change directions to expedite the development of a possible vaccine and also accelerate in the quest for newer antiviral agents.

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