Mild to Severe Neurological Manifestations of COVID-19: Cases Reports
anosmia, Intensive care unit, Covid-19 outbreak, encephalitis thrombosis
The main focus of Coronavirus disease 2019 (COVID-19) infection is pulmonary complications through virus-related neurological manifestations, ranging from mild to severe, such as encephalitis, cerebral thrombosis, neurocognitive (dementia-like) syndrome, and delirium. The hospital screening procedures for quickly recognizing neurological manifestations of COVID-19 are often complicated by other coexisting symptoms and can be obscured by the deep sedation procedures required for critically ill patients. Here, we present two different case-reports of COVID-19 patients, describing neurological complications, diagnostic imaging such as olfactory bulb damage (a mild and unclear underestimated complication) and a severe and sudden thrombotic stroke complicated with hemorrhage with a low-level cytokine storm and respiratory symptom resolution. We discuss the possible mechanisms of virus entrance, together with the causes of COVID-19-related encephalitis, olfactory bulb damage, ischemic stroke, and intracranial hemorrhage.
Gabriele Melegari, Veronica Rivi, Gabriele Zelent, Vincenzo Nasillo, Elena De Santis, Alessandra Melegari, Claudia Bevilacqua, Michele Zoli, Stefano Meletti, Alberto Barbieri