Table 1 Neruologic manifestation of COVID-19 infection according to publications included

Koh JS, and colleagues [4]

2020/Singapore

Prospective multi-center cohort study

47,572 confirmed COVID-19 patients (84.4% mild symptoms or asymptomatic, 2.2% severe symptoms and 13.3% critical); median age 34 years old; 98% male

4 patients with ADEM/encephalitis; 25 patients with Acute ischemic stroke or TIA or intracerebral hemorrhage; 7 patients with mono and polyneuropathies

4 patients with dysautonomia

Loss of consciousness, spastic paralysis (quadriparesis), transient ocular flutter, right and left hemiplegia/hemiparesis

CSF (various results), brain MRI (white matter lesion, brainstem lesion, spinal cord lesion), multi-focal hemorrhagic lesion predominantly in white matter

Mao and colleagues [5]

2020/China

Retrospective, observational study

214 confirmed COVID-19 patients; average age 52.7 years old; 87 (40.7%) men

Acute ischemic stroke (4 patients), intracerebral hemorrhage (1 patient)

CNS symptoms: altered consciousness, headache, dizziness, sudden onset hemiplegia, convulsive seizure and ataxia

PNS symptoms: taste, smell and vision impairment, neuropathic pain

—

Lu and colleagues [6]

2020/China

Retrospective multi-center study

304 people (discharged or died from COVID-19)

Acute symptomatic seizure

Generalized tonic-clonic seizure

EEG (not routine due to exposure concern)

Chandrasekaran and colleagues  [7]

2020/Philippines

Case report

62 years old, female (history of hypertension, prediabetes, dyslipidemia and TIA)

Acute ischemic stroke

Sudden dysarthria; sudden right side hemiparesis

Brain CT scan (hypodensity of left corona radiata); CT-angiography (left M1-segment of MCA stenosis)

Kamal YM and colleagues [8]

2020/United Arab Emirates

Case report

31 years old, man, previously healthy

Encephalitis

Physical and verbal aggressivity; altered mental status; abnormal behavior

Non-contrast brain CT scan (multiple hypodensities in the external capsule bilaterally, insular cortex and deep periventricular white matter of frontal lobe bilaterally); brain MRI with contrast (hyperintensity lesion of temporal lobe bilaterally with involvement of parasagittal frontal lobes bilaterally in FLAIR and T2-weighted image)

Khalifa and colleagues [9]

2020/Palestine

Case report

11 years old boy

Guillain-Barré syndrome

Acute unsteady gait, inability to walk and climb stairs; Symmetrical weakness of lower limb (strength 3/5), hypotonia, ankle and knee areflexia;

tingling sensation in legs and feet bilaterally, impaired proprioception

Whole spine MRI with contrast (enhancement of cauda equina nerve roots); nerve conduction study (consistent with demyelination polyneuropathy)

Wang and colleagues [10]

2020/China

Case report

68 years old man

Mental abnormalities associated with COVID-19 with CNS and PNS symptoms

Loss of consciousness, headache, dizziness; trembling of the hands, neck stiffness, muscle weakness (4/5 strength); persecution delusion

Brain CT scan (lacunar lesion in left basal ganglia)

Kwon and colleagues [11]

2020/South Korea

Case series

59 years old male (hypertension, diabetes, CKD);

84 years old male (hypertension, hyperlipidemia, pulmonary tuberculosis);

65 years old male (chronic heart disease);

87 years old female (hypertension, AF, heart failure);

83 years old male (hypertension, CKD)

Acute ischemic stroke

Sudden onset Hemiparesis, dysarthria, altered mental status

Brain CT scan, Brain MRI, CT-angiography, MR-angiography

(2 patients right MCA lesion; 2 patients left MCA lesion; 1 unknown result)

Wada and colleagues [12]

2020/Japan

Case report

69 years old man (diabetes mellitus)

Guillain-Barré syndrome

Loss of consciousness; Ankle and knee hyporeflexia, paraparesis inferior (strength 4/5)