Neuro Covid: Parsing the Persistent Neurological Puzzle Posed by the Pandemic

Numerous case reports and studies have documented various neurological complications in patients with SARS-CoV-2 infection since the COVID-19 pandemic. However, limitations in study designs and a lack of standardized evaluations have made it difficult to determine causality or characterize risks. This narrative literature review compiles and analyzes current knowledge on acute neurological symptoms associated with SARS-CoV-2 infection and identifies gaps requiring further research. Relevant articles published from January 2020 onward, including case reports, case series, cohort, and review studies available in English, were included by searching databases such as PubMed and Google Scholar. Studies have reported cognitive issues like “brain fog” and memory problems, mood changes such as depression, anxiety and PTSD-like symptoms, sensory disturbances, particularly smell and taste loss, fatigue, headaches, dizziness and rare but severe manifestations. Proposed mechanisms involve direct viral invasion of the nervous system or immune-mediated neuroinflammation. While initial reports provided early insights, rigorous prospective cohort studies with standardized evaluations are still needed to establish causality, elucidate pathophysiology, identify prognostic biomarkers and guide management of SARS-CoV-2’s neurological effects. Addressing current evidence gaps through well-designed international collaborative research is imperative.