NeuroCOVID. Insights into the clinical manifestations and pathophysiology

The Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), led to a global pandemic that placed the world in the worst health situation of the last century. To date, more than 675 million cases and 6.92 million deaths have been reported throughout the world. Three years after the first cases were detected, medical science is in a much better position to understand this new disease and to evaluate its complications and sequels. Involvement of the nervous system was quickly identified, especially in hospitalized patients; the first report was in 214 patients in Wuhan, 78 of whom (36.4%) exhibited characteristic neurologic manifestations of SARS-CoV-2 infection. Among the most outstanding were taste and smell impairment, headache, delirium, encephalopathy, acute psychiatric manifestations, cerebrovascular disease, seizures, myopathy, peripheral nerve involvement, and ocular disorders. There is a growing number of cases exhibiting complex longstanding neurological symptoms (long COVID) which lie across a frontier between psychological and functional neurological disorders, and are still poorly understood, constituting a great challenge for medical practitioners and researchers. Additionally, inflammation is a crucial actor in COVID-19, ranging from the effects of an exaggerated pro-inflammatory response (cytokine storm), leading to acute respiratory distress syndrome (ARDS) and death through the direct involvement of the brain stem, to the long-term occurrence of neurodegenerative disorders due to the development of systemic inflammation secondary to SARS-CoV-2 infection.

An important issue to consider is the neuroinvasive potential of SARS-CoV-2. Considering that evidence strongly supports the association of neurological involvement with the lethality of SARS-CoV-2 infection, it is crucial to know how the different variants reach the brain stem, and to what extent this phenomenon can contribute to inducing ARDS resistance to treatment.

Furthermore, other factors participate and need to be taken into account for research purposes and their link with public health policies to manage the contribution of COVID-19 to the global burden of brain disorders. In general, the frontier between psychological and functional neurological disorders is extremely blurry; but in the case of COVID-19, it is even more so. The convergence and interaction of neural, psychological and social causal mechanisms cannot be overlooked on the road to shortening the time between research and the improvement of people’s lives globally.

This Research Topic aims to approach the relevant neurological manifestations of acute COVID-19 and long-lasting post-infectious syndromes, associated risk factors (including psychosocial), pathophysiology, and development of predictive and outcome biomarkers (imaging, neurochemical, neurophysiological, among others). Investigation of the differences in the neuroinvasive mechanisms of SARS-CoV-2 variants of interest and their clinical consequences needs to be emphasized.

Contributions related to this Research Topic could help accumulate the most recent findings and help not only to increase the still scarce knowledge surrounding these topics but also to improve the clinical management of the patients and set new avenues for continuing research. Thus, submissions related to these themes of any type of manuscript supported by the journal are welcome (Original Research, Brief Research Report, Review, etc.).