{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,13]],"date-time":"2026-03-13T10:01:27Z","timestamp":1773396087303,"version":"3.50.1"},"reference-count":62,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T00:00:00Z","timestamp":1634688000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:p>Many reports suggest the SARS-CoV-2 infection may result in neurological complications. A wide spectrum of clinical syndromes have been reported, including both central and peripheral nervous system. Such symptoms may be a consequence of a direct viral injury, secondary to systemic inflammatory response, autoimmune processes, ischemic lesions or combination of these. Anosmia and dysgeusia are highly prevalent in the early stage of infection. Cerebrovascular events in patients with COVID-19 have also been documented with increasing frequency. Some cases of parainfectious autoimmune neurologic manifestations concurrent with active SARS-CoV-2 infection have been described, including hemorrhagic necrotizing encephalopathy, Guillain-Barr\u00e9 and Miller-Fisher syndromes. There are also a few reports documenting encephalitis and acute demyelinating encephalomyelitis (ADEM) in the course of COVID-19. There is also a growing number of cases of patients after recovery from COVID-19 with psychosomatic disorders, manifesting with memory disfunction, cognitive functions disorders, depression or other affective disorders, which may lead to a decrease of intellectual functions. Many of these neurological manifestations of the infection are possible to distinguish using radiological imaging techniques. It plays a very important role in evaluating the course of COVID-19 as well as diagnosing respiratory complications and choosing a proper management of infected patients. Similarly, radiological techniques play crucial role in identifying the cause of neurological symptoms connected to SARS-CoV-2 infection, being one of the most important elements of diagnostics. Especially in case of the presence of nervous system implication, using radiological imaging techniques to monitor the emerging onset of various symptoms is crucial to assess the severity and scope of involvement. Quick diagnostic process and identifying complications as fast as possible in order to implement specific treatment can be crucial to avoid long-term secondary conditions and accelerate the recovery period. In this review, we present the most important neurological complications that may occur in the course of SARS-CoV-2 infection and summarize their radiological manifestations.<\/jats:p>","DOI":"10.3389\/fneur.2021.711026","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T22:42:42Z","timestamp":1634769762000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Radiological Manifestation of Neurological Complications in the Course of SARS-CoV-2 Infection"],"prefix":"10.3389","volume":"12","author":[{"given":"Katarzyna","family":"Sklinda","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u0142gorzata","family":"Dorobek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr G.","family":"Wasilewski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karol","family":"Dre\u017cewski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"D\u0229bicka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jerzy","family":"Walecki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bartosz","family":"Mruk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,10,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.neurad.2020.06.007","article-title":"Neuroimaging and neurologic findings in COVID-19 and other coronavirus infections: a systematic review in 116 patients","volume":"48","author":"Katal","year":"2021","journal-title":"J Neuroradiol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1365","DOI":"10.3174\/ajnr.A6627","article-title":"Neurologic involvement in COVID-19: CAUSE OR COINCIDENCE? A neuroimaging perspective","volume":"41","author":"Pons-Escoda","year":"2020","journal-title":"Am J Neuroradiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"3104","DOI":"10.1093\/brain\/awaa240","article-title":"The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings","volume":"143","author":"Paterson","year":"2020","journal-title":"Brain."},{"key":"B4","doi-asserted-by":"publisher","first-page":"135564","DOI":"10.1016\/j.neulet.2020.135564","article-title":"Stroke in patients with COVID-19: clinical and neuroimaging characteristics","volume":"743","author":"Vogrig","year":"2021","journal-title":"Neurosci Lett."},{"key":"B5","doi-asserted-by":"publisher","first-page":"E242","DOI":"10.1148\/radiol.2020202222","article-title":"Brain MRI findings in severe COVID-19: a retrospective observational study","volume":"297","author":"Kremer","year":"2020","journal-title":"Radiology."},{"key":"B6","doi-asserted-by":"publisher","first-page":"E119","DOI":"10.1148\/radiol.2020201187","article-title":"COVID-19-associated acute hemorrhagic necrotizing encephalopathy: imaging features","volume":"296","author":"Poyiadji","year":"2020","journal-title":"Radiology."},{"key":"B7","doi-asserted-by":"publisher","first-page":"117085","DOI":"10.1016\/j.jns.2020.117085","article-title":"Neurological complications of coronavirus infection; a comparative review and lessons learned during the COVID-19 pandemic","volume":"417","author":"Sharifian-Dorche","year":"2020","journal-title":"J Neurol Sci."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1574","DOI":"10.1148\/rg.2020200149","article-title":"Multisystem imaging manifestations of COVID-19, part 1: viral pathogenesis and pulmonary and vascular system complications","volume":"40","author":"Revzin","year":"2020","journal-title":"Radiographics."},{"key":"B9","doi-asserted-by":"publisher","first-page":"782","DOI":"10.1001\/jama.2020.12839","article-title":"Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review","volume":"324","author":"Wiersinga","year":"2020","journal-title":"J Am Med Assoc."},{"key":"B10","doi-asserted-by":"publisher","first-page":"3039","DOI":"10.1007\/s10072-020-04708-8","article-title":"Neuromuscular presentations in patients with COVID-19","volume":"41","author":"Paliwal","year":"2020","journal-title":"Neurol Sci."},{"key":"B11","doi-asserted-by":"publisher","first-page":"577436","DOI":"10.1016\/j.jneuroim.2020.577436","article-title":"SARS-CoV-2 and nervous system: From pathogenesis to clinical manifestation","volume":"350","author":"Keyhanian","year":"2020","journal-title":"J Neuroimmunol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1021\/acschemneuro.0c00122","article-title":"Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms","volume":"11","author":"Baig","year":"2020","journal-title":"ACS Chem Neurosci."},{"key":"B13","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.ijid.2020.03.062","article-title":"A first case of meningitis\/encephalitis associated with SARS-Coronavirus-2","volume":"94","author":"Moriguchi","year":"2020","journal-title":"Int J Infect Dis."},{"key":"B14","doi-asserted-by":"publisher","first-page":"116832","DOI":"10.1016\/j.jns.2020.116832","article-title":"Central nervous system manifestations of COVID-19: a systematic review","volume":"413","author":"Asadi-Pooya","year":"2020","journal-title":"J Neurol Sci."},{"key":"B15","doi-asserted-by":"publisher","first-page":"1054","DOI":"10.1016\/S0140-6736(20)30566-3","article-title":"Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study","volume":"395","author":"Zhou","year":"2020","journal-title":"Lancet."},{"key":"B16","doi-asserted-by":"publisher","first-page":"1094","DOI":"10.1111\/jth.14817","article-title":"Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy","volume":"18","author":"Tang","year":"2020","journal-title":"J Thromb Haemost."},{"key":"B17","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/S1474-4422(20)30109-5","article-title":"Guillain-Barr\u00e9 syndrome associated with SARS-CoV-2 infection: causality or coincidence?","volume":"19","author":"Zhao","year":"2020","journal-title":"Lancet Neurol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"2574","DOI":"10.1056\/NEJMc2009191","article-title":"Guillain-Barr\u00e9 syndrome associated with SARS-CoV-2","volume":"382","author":"Toscano","year":"2020","journal-title":"N Engl J Med."},{"key":"B19","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1001\/jamaneurol.2020.1127","article-title":"Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China","volume":"77","author":"Mao","year":"2020","journal-title":"JAMA Neurol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"889","DOI":"10.1093\/cid\/ciaa330","article-title":"Self-reported olfactory and taste disorders in patients with severe acute respiratory coronavirus 2 infection: a cross-sectional study","volume":"71","author":"Giacomelli","year":"2020","journal-title":"Clin Infect Dis."},{"key":"B21","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1016\/j.bbi.2020.03.031","article-title":"Nervous system involvement after infection with COVID-19 and other coronaviruses","volume":"87","author":"Wu","year":"2020","journal-title":"Brain Behav Immun."},{"key":"B22","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.thromres.2020.04.013","article-title":"Incidence of thrombotic complications in critically ill ICU patients with COVID-19","volume":"191","author":"Klok","year":"2020","journal-title":"Thromb Res."},{"key":"B23","doi-asserted-by":"publisher","first-page":"279","DOI":"10.1136\/svn-2020-000431","article-title":"Acute cerebrovascular disease following COVID-19: a single center, retrospective, observational study","volume":"5","author":"Li","year":"2020","journal-title":"Stroke Vasc Neurol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1002\/mus.27024","article-title":"COVID-19-associated Guillain-Barr\u00e9 syndrome: the early pandemic experience","volume":"62","author":"Caress","year":"2020","journal-title":"Muscle Nerve."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1184","DOI":"10.3174\/ajnr.A6609","article-title":"COVID-19-associated miller fisher syndrome: MRI findings","volume":"41","author":"Lantos","year":"2020","journal-title":"Am J Neuroradiol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1179","DOI":"10.3174\/ajnr.A6610","article-title":"Brain imaging use and findings in COVID-19: a single academic center experience in the epicenter of disease in the United States","volume":"41","author":"Radmanesh","year":"2020","journal-title":"Am J Neuroradiol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"104984","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.104984","article-title":"Hemorrhagic stroke and anticoagulation in COVID-19","volume":"29","author":"Dogra","year":"2020","journal-title":"J Stroke Cerebrovasc Dis."},{"key":"B28","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1136\/jnnp-2020-323522","article-title":"Status of SARS-CoV-2 in cerebrospinal fluid of patients with COVID-19 and stroke","volume":"91","author":"Al Saiegh","year":"2020","journal-title":"J Neurol Neurosurg Psychiatry."},{"key":"B29","doi-asserted-by":"publisher","first-page":"116969","DOI":"10.1016\/j.jns.2020.116969","article-title":"Neurological manifestations and COVID-19: experiences from a tertiary care center at the Frontline","volume":"415","author":"Pinna","year":"2020","journal-title":"J Neurol Sci."},{"key":"B30","doi-asserted-by":"publisher","first-page":"1370","DOI":"10.3174\/ajnr.A6644","article-title":"Cerebral venous thrombosis associated with COVID-19","volume":"41","author":"Cavalcanti","year":"2020","journal-title":"Am J Neuroradiol."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1384","DOI":"10.3174\/ajnr.A6651","article-title":"COVID-19 neurologic complication with CNS vasculitis-like pattern","volume":"41","author":"Hanafi","year":"2020","journal-title":"Am J Neuroradiol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"116923","DOI":"10.1016\/j.jns.2020.116923","article-title":"COVID-19 related neuroimaging findings: a signal of thromboembolic complications and a strong prognostic marker of poor patient outcome","volume":"414","author":"Jain","year":"2020","journal-title":"J Neurol Sci."},{"key":"B33","doi-asserted-by":"publisher","first-page":"e1060","DOI":"10.1212\/WNL.0000000000009937","article-title":"Neurologic manifestations in hospitalized patients with COVID-19: the ALBACOVID registry","volume":"95","author":"Romero-S\u00e1nchez","year":"2020","journal-title":"Neurology."},{"key":"B34","doi-asserted-by":"publisher","first-page":"E270","DOI":"10.1148\/radiol.2020201933","article-title":"Imaging of neurologic disease in hospitalized patients with COVID-19: an Italian multicenter retrospective observational study","volume":"297","author":"Mahammedi","year":"2020","journal-title":"Radiology."},{"key":"B35","doi-asserted-by":"publisher","first-page":"105357","DOI":"10.1016\/j.jstrokecerebrovasdis.2020.105357","article-title":"Postpartum atypical posterior reversible encephalopathy syndrome in a COVID-19 patient - an obstetric emergency","volume":"29","author":"Sripadma","year":"2020","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"B36","doi-asserted-by":"publisher","first-page":"116858","DOI":"10.1016\/j.jns.2020.116858","article-title":"Transient cortical blindness in COVID-19 pneumonia; a PRES-like syndrome: case report","volume":"413","author":"Kaya","year":"2020","journal-title":"J Neurol Sci."},{"key":"B37","doi-asserted-by":"publisher","first-page":"2799","DOI":"10.1007\/s00415-020-09951-9","article-title":"COVID-19-associated acute disseminated encephalomyelitis (ADEM)","volume":"267","author":"Parsons","year":"2020","journal-title":"J Neurol."},{"key":"B38","doi-asserted-by":"publisher","first-page":"e797","DOI":"10.1212\/NXI.0000000000000797","article-title":"Acute disseminated encephalomyelitis after SARS-CoV-2 infection","volume":"7","author":"Novi","year":"2020","journal-title":"Neurol Neuroimmunol Neuroinflamm"},{"key":"B39","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1007\/s004010000331","article-title":"Coronaviruses in brain tissue from patients with multiple sclerosis","volume":"101","author":"Dessau","year":"2001","journal-title":"Acta Neuropathol."},{"key":"B40","doi-asserted-by":"publisher","first-page":"3338","DOI":"10.1128\/JVI.73.4.3338-3350.1999","article-title":"Acute and persistent infection of human neural cell lines by human coronavirus OC43","volume":"73","author":"Arbour","year":"1999","journal-title":"J Virol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"102377","DOI":"10.1016\/j.msard.2020.102377","article-title":"Multiple sclerosis following SARS-CoV-2 infection","volume":"45","author":"Palao","year":"2020","journal-title":"Mult Scler Relat Disord."},{"key":"B42","doi-asserted-by":"publisher","first-page":"100299","DOI":"10.1016\/j.ensci.2020.100299","article-title":"A first presentation of multiple sclerosis with concurrent COVID-19 infection","volume":"22","author":"Moore","year":"2021","journal-title":"eNeurologicalSci."},{"key":"B43","doi-asserted-by":"publisher","first-page":"102947","DOI":"10.1016\/j.msard.2021.102947","article-title":"Can coronavirus disease 2019 (COVID-19) trigger exacerbation of multiple sclerosis? A retrospective study","volume":"52","author":"Barzegar","year":"2021","journal-title":"Mult Scler Relat Disord."},{"key":"B44","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1136\/jnnp.64.6.736","article-title":"Clinical relapses and disease activity on magnetic resonance imaging associated with viral upper respiratory tract infections in multiple sclerosis","volume":"64","author":"Edwards","year":"1998","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B45","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1191\/1352458504ms1005oa","article-title":"Multiple sclerosis attacks are associated with picornavirus infections","volume":"10","author":"Kriesel","year":"2004","journal-title":"Mult Scler."},{"key":"B46","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1001\/jama.2020.0757","article-title":"Coronavirus infections-more than just the common cold","volume":"323","author":"Paules","year":"2020","journal-title":"J Am Med Assoc."},{"key":"B47","doi-asserted-by":"publisher","first-page":"2035","DOI":"10.1007\/s00415-020-10201-1","article-title":"Bickerstaff encephalitis after COVID-19","volume":"268","author":"Llorente Ayuso","year":"2021","journal-title":"J Neurol."},{"key":"B48","doi-asserted-by":"publisher","first-page":"10","DOI":"10.7196\/SAMJ.2020.v111i11.15433","article-title":"Long-COVID: an evolving problem with an extensive impact","volume":"111","author":"Mendelson","year":"2020","journal-title":"S Afr Med J."},{"key":"B49","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1186\/s13195-020-00744-w","article-title":"Cognitive impact of COVID-19: looking beyond the short term","volume":"12","author":"Miners","year":"2020","journal-title":"Alzheimers Res Ther."},{"key":"B50","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.neuroscience.2013.11.026","article-title":"Disconnected aging: cerebral white matter integrity and age-related differences in cognition","volume":"276","author":"Bennett","year":"2014","journal-title":"Neuroscience."},{"key":"B51","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1016\/j.neuroimage.2010.11.016","article-title":"Cortico-striatal connectivity and cognition in normal aging: a combined DTI and resting state fMRI study","volume":"55","author":"Ystad","year":"2011","journal-title":"Neuroimage."},{"key":"B52","doi-asserted-by":"publisher","first-page":"100484","DOI":"10.1016\/j.eclinm.2020.100484","article-title":"Cerebral micro-structural changes in COVID-19 patients - an MRI-based 3-month follow-up study","volume":"25","author":"Lu","year":"2020","journal-title":"EClinicalMedicine."},{"key":"B53","doi-asserted-by":"publisher","first-page":"653786","DOI":"10.3389\/fimmu.2021.653786","article-title":"Acute transverse myelitis (ATM): clinical review of 43 patients with COVID-19-associated ATM and 3 post-vaccination ATM serious adverse events with the ChAdOx1 nCoV-19 vaccine (AZD1222)","volume":"12","author":"Rom\u00e1n","year":"2021","journal-title":"Front Immunol."},{"key":"B54","doi-asserted-by":"publisher","first-page":"14952","DOI":"10.1111\/ene.14952","article-title":"Systematic review of cases of acute myelitis in individuals with COVID-19","volume":"2021","author":"Schulte","year":"2021","journal-title":"Eur J Neurol"},{"key":"B55","doi-asserted-by":"publisher","first-page":"293","DOI":"10.7861\/clinmed.2020-0182","article-title":"Lessons of the month 1: a case of rhombencephalitis as a rare complication of acute COVID-19 infection","volume":"20","author":"Wong","year":"2020","journal-title":"Clin Med."},{"key":"B56","doi-asserted-by":"publisher","first-page":"321","DOI":"10.5811\/cpcem.2020.5.47937","article-title":"A case report of acute transverse myelitis following novel coronavirus infection","volume":"4","author":"Sarma","year":"2020","journal-title":"Clin Pract Cases Emerg Med."},{"key":"B57","doi-asserted-by":"publisher","first-page":"2251","DOI":"10.1007\/s00405-020-05965-1","article-title":"Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study","volume":"277","author":"Lechien","year":"2020","journal-title":"Eur Arch Otorhinolaryngol."},{"key":"B58","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1016\/j.acra.2020.10.006","article-title":"Olfactory bulb MRI and paranasal sinus CT findings in persistent COVID-19 anosmia","volume":"28","author":"Kandemirli","year":"2021","journal-title":"Acad Radiol."},{"key":"B59","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1002\/ana.25807","article-title":"COVID-19: a global threat to the nervous system","volume":"88","author":"Koralnik","year":"2020","journal-title":"Ann Neurol."},{"key":"B60","doi-asserted-by":"publisher","first-page":"E117","DOI":"10.1148\/radiol.2020203116","article-title":"Imaging review of peripheral nerve injuries in patients with COVID-19","volume":"298","author":"Fernandez","year":"2021","journal-title":"Radiology."},{"key":"B61","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1007\/s00256-021-03734-7","article-title":"Musculoskeletal involvement of COVID-19: review of imaging","volume":"50","author":"Ramani","year":"2021","journal-title":"Skeletal Radiol."},{"key":"B62","doi-asserted-by":"publisher","first-page":"3437","DOI":"10.1007\/s10072-020-04801-y","article-title":"Neurological manifestations of COVID-19: a systematic review and meta-analysis of proportions","volume":"41","author":"Favas","year":"2020","journal-title":"Neurol Sci."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.711026\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T22:42:44Z","timestamp":1634769764000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2021.711026\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,20]]},"references-count":62,"alternative-id":["10.3389\/fneur.2021.711026"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2021.711026","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,20]]},"article-number":"711026"}}