{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T10:32:00Z","timestamp":1784543520269,"version":"3.55.0"},"reference-count":63,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"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>The main focus of Coronavirus disease 2019 (COVID-19) infection is pulmonary complications through virus-related neurological manifestations, ranging from mild to severe, such as encephalitis, cerebral thrombosis, neurocognitive (dementia-like) syndrome, and delirium. The hospital screening procedures for quickly recognizing neurological manifestations of COVID-19 are often complicated by other coexisting symptoms and can be obscured by the deep sedation procedures required for critically ill patients. Here, we present two different case-reports of COVID-19 patients, describing neurological complications, diagnostic imaging such as olfactory bulb damage (a mild and unclear underestimated complication) and a severe and sudden thrombotic stroke complicated with hemorrhage with a low-level cytokine storm and respiratory symptom resolution. We discuss the possible mechanisms of virus entrance, together with the causes of COVID-19-related encephalitis, olfactory bulb damage, ischemic stroke, and intracranial hemorrhage.<\/jats:p>","DOI":"10.3390\/ijerph18073673","type":"journal-article","created":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T07:23:17Z","timestamp":1617261797000},"page":"3673","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Mild to Severe Neurological Manifestations of COVID-19: Cases Reports"],"prefix":"10.3390","volume":"18","author":[{"given":"Gabriele","family":"Melegari","sequence":"first","affiliation":[{"name":"Anaesthesia and Intensive Care, Azienda Ospedaliero-Universitaria di Modena, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8413-4510","authenticated-orcid":false,"given":"Veronica","family":"Rivi","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic and Neural Sciences, Neuroscience Post Graduate School, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriele","family":"Zelent","sequence":"additional","affiliation":[{"name":"Neuroradiology, Azienda Ospedaliero-Universitaria di Modena, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5122-5574","authenticated-orcid":false,"given":"Vincenzo","family":"Nasillo","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Azienda Unit\u00e0 Sanitaria Locale, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"De Santis","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Azienda Unit\u00e0 Sanitaria Locale, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Melegari","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Azienda Unit\u00e0 Sanitaria Locale, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Bevilacqua","sequence":"additional","affiliation":[{"name":"School of Anaesthesia and Intensive Care, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Zoli","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Metabolic and Neural Sciences, Neuroscience Post Graduate School, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0334-539X","authenticated-orcid":false,"given":"Stefano","family":"Meletti","sequence":"additional","affiliation":[{"name":"Neurology, Azienda Ospedaliera Universitaria di Modena, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Barbieri","sequence":"additional","affiliation":[{"name":"School of Anaesthesia and Intensive Care, University of Modena and Reggio Emilia, 41125 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e49","DOI":"10.1016\/S0140-6736(20)30493-1","article-title":"The response of Milan\u2019s Emergency Medical System to the COVID-19 outbreak in Italy","volume":"395","author":"Spina","year":"2020","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1016\/j.medin.2020.04.007","article-title":"Novel coronavirus (2019-nCov): Do you have enough intensive care units?","volume":"44","author":"Melegari","year":"2020","journal-title":"Med. 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