{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T22:29:19Z","timestamp":1773095359911,"version":"3.50.1"},"reference-count":71,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T00:00:00Z","timestamp":1604188800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Coronavirus (SARS-CoV-2) emerged in China in December 2019 and rapidly caused a global health pandemic. Current evidence seems to suggest a possible link with ecosystem disequilibrium and even air pollution. The primary manifestations affect respiratory and circulatory systems, but neurological features are also being reported through case reports and case series. We summarize neurological symptoms and complications associated with COVID-19. We have searched for original articles published in PubMed\/Medline, PubMed Central and Google Scholar using the following keywords: \u201cCOVID-19\u201d, \u201cCoronavirus\u201d, \u201cpandemic\u201d, \u201cSARS-COV-2\u201d, \u201cneurology\u201d, \u201cneurological\u201d, \u201ccomplications\u201d and \u201cmanifestations\u201d. We found around 1000 publications addressing the issue of neurological conditions associated with COVID-19 infection. Amongst those, headache and dizziness are the most common reported symptoms followed by encephalopathy and delirium, while the most frequent complications are cerebrovascular accidents, Guillain\u2013Barr\u00e9 syndrome, acute transverse myelitis, and acute encephalitis. Specific symptoms affecting the peripheral nervous system such as hyposmia and dysgeusia are the most common manifestations recorded in the selected studies. Interestingly, it was noted that these kinds of neurological symptoms might precede the typical features, such as fever and cough, in COVID patients. Neurological symptoms and complications associated with COVID-19 should be considered as a part of the clinical features of this novel global pandemic.<\/jats:p>","DOI":"10.3390\/ijerph17218049","type":"journal-article","created":{"date-parts":[[2020,11,1]],"date-time":"2020-11-01T20:05:25Z","timestamp":1604261125000},"page":"8049","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Environmental Issues and Neurological Manifestations Associated with COVID-19 Pandemic: New Aspects of the Disease?"],"prefix":"10.3390","volume":"17","author":[{"given":"Luigi","family":"Bellocchio","sequence":"first","affiliation":[{"name":"INSERM, U1215 NeuroCentre Magendie, Endocannabinoids and Neuroadaptation, University of Bordeaux, 33000 Bordeaux, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ioana Roxana","family":"Bordea","sequence":"additional","affiliation":[{"name":"Department of Oral Rehabilitation, Faculty of Dentistry, Iuliu Ha\u021bieganu University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8758-1415","authenticated-orcid":false,"given":"Andrea","family":"Ballini","sequence":"additional","affiliation":[{"name":"Department of Biosciences, Biotechnologies and Biopharmaceutics, Campus Universitario \u201cErnesto Quagliariello\u201d University of Bari \u201cAldo Moro\u201d, 70125 Bari, Italy"},{"name":"Department of Precision Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2660-9231","authenticated-orcid":false,"given":"Felice","family":"Lorusso","sequence":"additional","affiliation":[{"name":"Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Denisa","family":"Hazballa","sequence":"additional","affiliation":[{"name":"Kongresi Elbasanit, Rruga: Aqif Pasha, 3001 Elbasan, Albania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ciro Gargiulo","family":"Isacco","sequence":"additional","affiliation":[{"name":"Embryology and Regenerative Medicine and Immunology at Pham Chau Trinh University of Medicine Hoi An, Ho Chi Minh 70000, Vietnam"},{"name":"Regenerative Medicine and Metabolic Disorders at Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppina","family":"Malcangi","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessio Danilo","family":"Inchingolo","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianna","family":"Dipalma","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Inchingolo","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Medicine, University of Medicine Aldo Moro, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4556-6182","authenticated-orcid":false,"given":"Prisco","family":"Piscitelli","sequence":"additional","affiliation":[{"name":"Staff UNESCO Chair on Health Education and Sustainable Development, Federico II University, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giancarlo","family":"Logroscino","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, 70121 Bari, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Miani","sequence":"additional","affiliation":[{"name":"Department of Environmental Sciences and Policy, University of Milan, 20068 Milan, Italy"},{"name":"Italian Society of Environmental Medicine, SIMA, 20068 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,11,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A novel coronavirus from patients with pneumonia in China","volume":"382","author":"Zhu","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/S1473-3099(20)30076-1","article-title":"Outbreak of coronavirus disease 2019","volume":"20","author":"Burki","year":"2020","journal-title":"Lancet Infect. Dis."},{"key":"ref_3","unstructured":"WHO (2020, July 07). Pneumonia of Unknown Cause\u2014China. Available online: https:\/\/www.who.int\/csr\/don\/05-january-2020-pneumonia-of-unkown-cause-china\/en\/."},{"key":"ref_4","unstructured":"WHO (2020, July 07). Director-General\u2019s Opening Remarks at the Media Briefing on COVID-19\u201411 March 2020. Available online: https:\/\/www.who.int\/dg\/speeches\/detail\/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3920","DOI":"10.12998\/wjcc.v8.i18.3920","article-title":"Special features of SARS-CoV2 in daily practice","volume":"8","author":"Charitos","year":"2020","journal-title":"World J. Clin. Cases"},{"key":"ref_6","first-page":"7173","article-title":"Rapid and sensitive diagnostic procedure for multiple detection of pandemic Coronaviridae family members SARS-CoV-2, SARS-CoV, MERS-CoV and HCoV: A translational research and cooperation between the Phan Chau Trinh University in Vietnam and University of Bari \u201cAldo Moro\u201d in Italy","volume":"24","author":"Pham","year":"2020","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Santacroce, L., Charitos, I.A., Ballini, A., Inchingolo, F., Luperto, P., De Nitto, E., and Topi, S. (2020). The Human Respiratory System and its Microbiome at a Glimpse. Biology (Basel), 9.","DOI":"10.3390\/biology9100318"},{"key":"ref_8","first-page":"176","article-title":"Editor responsibility and scientific integrity during the COVID-19 outbreak","volume":"37","author":"Uzun","year":"2020","journal-title":"Balk. Med. J."},{"key":"ref_9","first-page":"236","article-title":"An analysis of global research on SARS-CoV-2","volume":"37","author":"Zhang","year":"2020","journal-title":"Sheng Wu Yi Xue Gong Cheng Xue Za Zhi"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Di Gennaro, F., Pizzol, D., Marotta, C., Antunes, M., Racalbuto, V., Veronese, N., and Smith, L. (2020). Coronavirus diseases (COVID-19) current status and future perspectives: A narrative review. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17082690"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Bordea, I.R., Xhajanka, E., Candrea, S., Bran, S., Oni\u0219or, F., Inchingolo, A.D., Malcangi, G., Pham, V.H., Inchingolo, A.M., and Scarano, A. (2020). Coronavirus (SARS-CoV-2) pandemic: Emerging and Future Challenges for Dental Practitioners. Mircoorganisms, 8.","DOI":"10.3390\/microorganisms8111704"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.jpha.2020.03.001","article-title":"Molecular immune pathogenesis and diagnosis of COVID-19","volume":"10","author":"Li","year":"2020","journal-title":"J. Pharm. Anal."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"15598","DOI":"10.3402\/tellusb.v64i0.15598","article-title":"Primary Biological Aerosol Particles in the Atmosphere: A Review","volume":"64","author":"Huffman","year":"2012","journal-title":"Tellus B Chem. Phys. Meteorol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1289\/ehp.0901782","article-title":"Ambient Influenza and Avian Influenza Virus during Dust Storm Days and Background Days","volume":"118","author":"Chen","year":"2010","journal-title":"Environ. Health Perspect."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1016\/j.envres.2017.03.046","article-title":"Is Short-Term Exposure to Ambient Fine Particles Associated with Measles Incidence in China? A Multi-City Study","volume":"156","author":"Chen","year":"2017","journal-title":"Environ. Res."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Zhao, Y., Richardson, B., Takle, E., Chai, L., Schmitt, D., and Xin, H. (2019). Airborne Transmission May Have Played a Role in the Spread of 2015 Highly Pathogenic Avian Influenza Outbreaks in the United States. Sci. Rep., 9.","DOI":"10.1038\/s41598-019-47788-z"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.atmosenv.2017.03.010","article-title":"Assessment for the Impact of Dust Events on Measles Incidence in Western China","volume":"157","author":"Ma","year":"2017","journal-title":"Atmos. Environ."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1080\/08958370701665434","article-title":"Air Pollution and Respiratory Viral Infection","volume":"19","author":"Ciencewicki","year":"2007","journal-title":"Inhal. Toxicol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"109754","DOI":"10.1016\/j.envres.2020.109754","article-title":"SARS-Cov-2RNA Found on Particulate Matter of Bergamo in Northern Italy: First Evidence","volume":"188","author":"Setti","year":"2020","journal-title":"Environ. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"109650","DOI":"10.1016\/j.envres.2020.109650","article-title":"Effects of air pollutants on the transmission and severity of respiratory viral infections","volume":"187","author":"Domingo","year":"2020","journal-title":"Environ. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"109861","DOI":"10.1016\/j.envres.2020.109861","article-title":"Influence of airborne transmission of SARS-CoV-2 on COVID-19 pandemic. A review","volume":"188","author":"Domingo","year":"2020","journal-title":"Environ. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"14857","DOI":"10.1073\/pnas.2009637117","article-title":"Identifying Airborne Transmission as the Dominant Route for the Spread of COVID-19","volume":"117","author":"Zhang","year":"2020","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Wu, X., Nethery, R.C., Sabath, B.M., Braun, D., and Dominici, F. (2020). Exposure to air pollution and COVID-19 mortality in the United States: A nationwide cross-sectional study. Prepr. Medrxiv.","DOI":"10.1101\/2020.04.05.20054502"},{"key":"ref_24","doi-asserted-by":"crossref","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":"ref_25","doi-asserted-by":"crossref","first-page":"2268","DOI":"10.1056\/NEJMc2008597","article-title":"Neurologic features in severe SARS-COV-2 infection","volume":"382","author":"Helms","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Manji, H., Carr, A.S., Brownlee, W.J., and Lunn, M.P. (2020). Neurology in the time of covid-19. J. Neurol. Neurosurg. Psychiatry Mon.","DOI":"10.1136\/jnnp-2020-323414"},{"key":"ref_27","unstructured":"(2020, July 07). Chapter 8: Assessing Risk of Bias in a Randomized Trial|Cochrane Training. Available online: https:\/\/training.cochrane.org\/handbook\/current\/chapter-08."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., and Altman, D.G. (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Wu, Y., Xu, X., Chen, Z., Duan, J., Hashimoto, K., Yang, L., Liu, C., and Yang, C. (2020). Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav. Immun., 87.","DOI":"10.1016\/j.bbi.2020.03.031"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.jocn.2020.04.124","article-title":"COVID-19, SARS and MERS: A neurological perspective","volume":"77","author":"Kwong","year":"2020","journal-title":"J. Clin. Neurosci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1002\/jmv.25728","article-title":"The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients","volume":"92","author":"Li","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_32","doi-asserted-by":"crossref","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":"ref_33","doi-asserted-by":"crossref","first-page":"37","DOI":"10.3389\/fnana.2020.00037","article-title":"Neuromechanisms of SARS-CoV-2: A Review","volume":"14","author":"DosSantos","year":"2020","journal-title":"Front. Neuroanat."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Nalleballe, K., Reddy Onteddu, S., Sharma, R., Dandu, V., Brown, A., Jasti, M., Yadala, S., Veerapaneni, K., Siddamreddy, S., and Avula, A. (2020). Spectrum of neuropsychiatric manifestations in COVID-19. Brain Behav. Immun.","DOI":"10.1016\/j.bbi.2020.06.020"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1033","DOI":"10.1016\/S0140-6736(20)30628-0","article-title":"COVID-19: Consider cytokine storm syndromes and immunosuppression","volume":"395","author":"Mehta","year":"2020","journal-title":"Lancet"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Tveito, K. (2020). Cytokinstormer ved covid-19?. Tidsskr. Den. Nor. Legeforening, 140.","DOI":"10.4045\/tidsskr.20.0239"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Filatov, A., Sharma, P., Hindi, F., and Espinosa, P.S. (2020). Neurological Complications of Coronavirus Disease (COVID-19): Encephalopathy. Cureus, 12.","DOI":"10.7759\/cureus.7352"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Espinosa, P.S., Rizvi, Z., Sharma, P., Hindi, F., and Filatov, A. (2020). Neurological Complications of Coronavirus Disease (COVID-19): Encephalopathy, MRI Brain and Cerebrospinal Fluid Findings: Case 2. Cureus, 12.","DOI":"10.7759\/cureus.7930"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Chen, T., Wu, D., Chen, H., Yan, W., Yang, D., Chen, G., Ma, K., Xu, D., Yu, H., and Wang, H. (2020). Clinical characteristics of 113 deceased patients with coronavirus disease 2019: Retrospective study. BMJ, 368.","DOI":"10.1136\/bmj.m1091"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"188","DOI":"10.1186\/s13054-020-02895-6","article-title":"Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China","volume":"24","author":"Wang","year":"2020","journal-title":"Crit. Care"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Poyiadji, N., Shahin, G., Noujaim, D., Stone, M., Patel, S., and Griffith, B. (2020). COVID-19\u2013associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features. Radiology, 201187.","DOI":"10.1148\/radiol.2020201187"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"E223","DOI":"10.1148\/radiol.2020202040","article-title":"COVID-19\u2013associated Diffuse Leukoencephalopathy and Microhemorrhages","volume":"297","author":"Radmanesh","year":"2020","journal-title":"Radiology"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"100669","DOI":"10.1016\/j.nmni.2020.100669","article-title":"COVID-19 and intra cerebral hemorrhage: Causative or coincidental","volume":"35","author":"Karimi","year":"2020","journal-title":"New Microbes New Infect."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"10022","DOI":"10.18632\/aging.103335","article-title":"Potential Mechanisms of Hemorrhagic Stroke in Elderly COVID-19 Patients","volume":"12","author":"Wang","year":"2020","journal-title":"Aging"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e60","DOI":"10.1056\/NEJMc2009787","article-title":"Large-vessel stroke as a presenting feature of Covid-19 in the young","volume":"382","author":"Oxley","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_46","doi-asserted-by":"crossref","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":"ref_47","doi-asserted-by":"crossref","first-page":"100091","DOI":"10.1016\/j.bbih.2020.100091","article-title":"Acute myelitis after SARS-CoV-2 infection: A case report","volume":"5","author":"Zhao","year":"2020","journal-title":"Brain Behav. Immun. Health"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1097\/CM9.0000000000000824","article-title":"Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 in Wuhan, China: A retrospective study","volume":"133","author":"Deng","year":"2020","journal-title":"Chin. Med. J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1002\/jmv.25757","article-title":"COVID-19 patients\u2019 clinical characteristics, discharge rate, and fatality rate of meta-analysis","volume":"92","author":"Li","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Wang, C., Horby, P.W., Hayden, F.G., and Gao, G.F. (2020). A novel coronavirus outbreak of global health concern. Lancet.","DOI":"10.1016\/S0140-6736(20)30185-9"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Yan, C.H., Faraji, F., Prajapati, D.P., Boone, C.E., and DeConde, A.S. (2020). Association of chemosensory dysfunction and Covid-19 in patients presenting with influenza-like symptoms. Int. Forum Allergy Rhinol., 10.","DOI":"10.1002\/alr.22579"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Lee, D.J., Lockwood, J., Das, P., Wang, R., Grinspun, E., and Lee, J.M. (2020). Self-reported anosmia and dysgeusia as key symptoms of coronavirus disease 2019. CJEM, 1\u20138.","DOI":"10.1017\/cem.2020.420"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Bagheri, S., Asghari, A., Farhadi, M., Shamshiri, A., Kabir, A., Kamrava, S., Jalessi, M., Mohebbi, A., Alizadeh, R., and Honarmand, A. (2020). Coincidence of COVID-19 Epidemic and Olfactory Dysfunction Outbreak. medRxiv.","DOI":"10.1101\/2020.03.23.20041889"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"von Bartheld, C.S., Hagen, M.M., and Butowt, R. (2020). Prevalence of Chemosensory Dysfunction in COVID-19 Patients: A Systematic Review and Meta-analysis Reveals Significant Ethnic Differences. medRxiv.","DOI":"10.1101\/2020.06.15.20132134"},{"key":"ref_56","doi-asserted-by":"crossref","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":"ref_57","doi-asserted-by":"crossref","unstructured":"Sedaghat, Z., and Karimi, N. (2020). Guillain Barre syndrome associated with COVID-19 infection: A case report. J. Clin. Neurosci., 76.","DOI":"10.1016\/j.jocn.2020.04.062"},{"key":"ref_58","doi-asserted-by":"crossref","unstructured":"Virani, A., Rabold, E., Hanson, T., Haag, A., Elrufay, R., Cheema, T., Balaan, M., and Bhanot, N. (2020). Guillain-Barr\u00e9 Syndrome associated with SARS-CoV-2 infection. IDCases, 20.","DOI":"10.1016\/j.idcr.2020.e00771"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Toscano, G., Palmerini, F., Ravaglia, S., Ruiz, L., Invernizzi, P., Cuzzoni, M.G., Franciotta, D., Baldanti, F., Daturi, R., and Postorino, P. (2020). Guillain\u2013Barr\u00e9 Syndrome Associated with SARS-CoV-2. N. Engl. J. Med., 382.","DOI":"10.1056\/NEJMc2009191"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"6049","DOI":"10.18632\/aging.103000","article-title":"Does comorbidity increase the risk of patients with covid-19: Evidence from meta-analysis","volume":"12","author":"Wang","year":"2020","journal-title":"Aging"},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Klok, F.A., Kruip, M.J.H.A., van der Meer, N.J.M., Arbous, M.S., Gommers, D.A.M.P.J., Kant, K.M., Kaptein, F.H.J., van Paassen, J., Stals, M.A.M., and Huisman, M.V. (2020). Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb. Res.","DOI":"10.1016\/j.thromres.2020.04.013"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"565","DOI":"10.3389\/fneur.2020.00565","article-title":"Neurologic Characteristics in Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis","volume":"11","author":"Pinzon","year":"2020","journal-title":"Front. Neurol."},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Narici, M., De Vito, G., Franchi, M., Paoli, A., Moro, T., Marcolin, G., Grassi, B., Baldassarre, G., Zuccarelli, L., and Biolo, G. (2020). Impact of sedentarism due to the COVID-19 home confinement on neuromuscular, cardiovascular and metabolic health: Physiological and pathophysiological implications and recommendations for physical and nutritional countermeasures. Eur. J. Sport Sci.","DOI":"10.1080\/17461391.2020.1761076"},{"key":"ref_64","doi-asserted-by":"crossref","unstructured":"Cai, J., Sun, W., Huang, J., Gamber, M., Wu, J., and He, G. (2020). Indirect Virus Transmission in Cluster of COVID-19 Cases, Wenzhou, China. Emerg. Infect. Dis. J. CDC, 26.","DOI":"10.3201\/eid2606.200412"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1016\/j.atmosenv.2003.10.014","article-title":"New Directions: Airborne Transmission of Foot-and-Mouth Disease Virus","volume":"38","author":"Gloster","year":"2004","journal-title":"Atmos. Environ."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1038\/s41396-017-0042-4","article-title":"Deposition Rates of Viruses and Bacteria above the Atmospheric Boundary Layer","volume":"12","author":"Reche","year":"2018","journal-title":"ISME J."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"20178","DOI":"10.1007\/s11356-016-7228-6","article-title":"Haze Is a Risk Factor Contributing to the Rapid Spread of Respiratory Syncytial Virus in Children","volume":"23","author":"Ye","year":"2016","journal-title":"Environ. Sci. Pollut. Res. Int."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"13524","DOI":"10.1007\/s11356-020-07903-4","article-title":"The Effects of Air Pollution and Meteorological Factors on Measles Cases in Lanzhou, China","volume":"27","author":"Peng","year":"2020","journal-title":"Environ. Sci. Pollut. Res. Int."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1056\/NEJMc2004973","article-title":"Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1","volume":"382","author":"Bushmaker","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Paules, C.I., Marston, H.D., and Fauci, A.S. (2020). Coronavirus Infections-More Than Just the Common Cold. JAMA.","DOI":"10.1001\/jama.2020.0757"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1159\/000508991","article-title":"COVID-19 Infection and Neurological Complications: Present Findings and Future Predictions","volume":"54","author":"Beghi","year":"2020","journal-title":"Neuroepidemiology"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/21\/8049\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:27:51Z","timestamp":1760178471000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/21\/8049"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,1]]},"references-count":71,"journal-issue":{"issue":"21","published-online":{"date-parts":[[2020,11]]}},"alternative-id":["ijerph17218049"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17218049","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,1]]}}}