Neuroimaging of Covid-19. First Insights based on Clinical Cases

Current available data show that involvement of the NS is frequent in patients with SARS-CoV-2 infection. The most common neurologic syndromes include cerebrovascular disorders, encephalopathies, inflammatory Central Nervous System (CNS) syndromes, peripheral neurologic disorders, psychiatric disorders. The pathophysiology of neurological manifestations is far from being understood. They can be coincidental, common complications of severe viral infection, or direct consequence of the viral infection either via indirect para-infective mechanisms or direct viral penetration of NS. Experimental animal models had previously demonstrated the neuroinvasive potential of SARS-CoV and the detection of viral particles in special structures such as the thalamus, nucleus ambiguous and nucleus of the solitary tract, suggesting that CNS invasion can contribute significantly to the severe outcome not only through direct damage to neurological structures, but also through a potential detrimental effect on cardiorespiratory responses. Up to now, the detection of SARS-CoV-2 RNA in the cerebrospinal fluid of COVID-19 patients has been reported occasionally and conclusive pathological demonstration of the virus in the CNS is lacking.