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

Lynn Tan; Zhiliang Caleb Lin; Jason Ray; Robb Wesselingh; Thomas J Oxley; James McFadyen; Mahima Kapoor; Elspeth Hutton

doi:10.1136/bmjno-2020-000101

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

BMJ Neurol Open. 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.

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.

Publication types

Review