COVID-19 and the central nervous system: what is more frequent?

Background: In 2020, SARS-Cov-2 was identified as responsible for pneumonia in Wuhan and declared by WHO to be a pandemic. The action of SARSCoV-2 with the angiotensin-converting enzyme 2 and the cytokine storm, can trigger acute cerebrovascular diseases, meningoencephalitis, arterial dysregulation and possible neurological consequences. With the involvement of the central nervous system (CNS), it is necessary to alert professionals to a possible increase in acute neurological cases and long-term follow-up. Objectives and methodology: To analyze the occurrence of signs and symptoms related to the COVID-19 infection, seeking to establish the most common and the most serious ones, through narrative review. Results: The symptoms related to the CNS were described in all the studies analyzed, with a higher occurrence of headache, altered level of consciousness, dizziness, myalgia, hypogeusia and hyposmia. Other quotes, to a lesser extent, were neuralgia and seizure episodes. Among the most worrying findings are cerebrovascular events, acute hemorrhagic necrotizing encephalopathy and GuillainBarré syndrome. As for cerebrovascular diseases, ischemic injuries and venous thrombosis can occur, from asymptomatic cases to severe cases. The importance of pre-existing risk factors in the cerebrovascular outcome is highlighted. Conclusions: Although the symptoms of primary infection are nonspecific and easily confused, CNS involvement can be fatal, citing cerebrovascular involvement as the most worrying finding. The occurrence of pre-existing risk factors should take the attention of the health professional, however, those who do not have them must also be carefully investigated from the signs and symptoms presented.