Brain and Covid-19: an integrative review

Abstract

Introduction: December 2019, an outbreak of Severe Acute Respiratory Distress Syndrome started in Wuhan, China. This injury spread rapidly until, in March 2020, the World Health Organization (WHO) declared a pandemic. Although respiratory symptoms are more reported, there is also evidence of impairment of the nervous system. Among the main neurological symptoms reported, the following stand out: headache, vertigo, altered consciousness, encephalopathies, cerebrovascular disease and seizures. Objectives: The objective of this study is to describe, based on the current literature, the main evidence of brain involvement by COVID-19 and its clinical manifestations. Methodology: This is an integrative literature review, carried out through the following databases: PubMed, LILACS, BIREME. The searches were limited to articles from the year 2020, in English and Portuguese. For this search, were used the descriptors indexed in MESH and DeCS “BRAIN” or “CEREBRAL” or “BRAIN INJURIES” or “CENTRAL NERVOUS SYSTEM” and “COVID-19” or “SARS-CoV-2”. Results: Through crossing of descriptors in the databases, and reverse search tools, 594 articles were found. Among these, 46 were selected to compose the sample. Discussion: Reports were found of patients with COVID-19 who had: benign intracranial hypertension, seizures, ischemic and hemorrhagic cerebrovascular diseases, acute necrotizing encephalopathy, Birkerstaff encephalitis, meningitis, and delirium. In addition, previous studies suggest that the involvement of the central nervous system by SARS-CoV-2 may induce an increase in neurodegenerative disorders in the future. Conclusion: It is a fact that the SARS-CoV-2 virus is capable of affecting the central nervous system. The clinical manifestations resulting from this are related to the greater severity of the condition, and a greater risk of unfavorable outcomes. Thus, it is imperative that the neurological examination of these patients is done extremely carefully, and that clinical findings are reported and notdisregarded.