{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T10:41:06Z","timestamp":1784371266561,"version":"3.55.0"},"reference-count":136,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T00:00:00Z","timestamp":1596153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Increasing evidence suggests that Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) can also invade the central nervous system (CNS). However, findings available on its neurological manifestations and their pathogenic mechanisms have not yet been systematically addressed. A literature search on neurological complications reported in patients with COVID-19 until June 2020 produced a total of 23 studies. Overall, these papers report that patients may exhibit a wide range of neurological manifestations, including encephalopathy, encephalitis, seizures, cerebrovascular events, acute polyneuropathy, headache, hypogeusia, and hyposmia, as well as some non-specific symptoms. Whether these features can be an indirect and unspecific consequence of the pulmonary disease or a generalized inflammatory state on the CNS remains to be determined; also, they may rather reflect direct SARS-CoV-2-related neuronal damage. Hematogenous versus transsynaptic propagation, the role of the angiotensin II converting enzyme receptor-2, the spread across the blood-brain barrier, the impact of the hyperimmune response (the so-called \u201ccytokine storm\u201d), and the possibility of virus persistence within some CNS resident cells are still debated. The different levels and severity of neurotropism and neurovirulence in patients with COVID-19 might be explained by a combination of viral and host factors and by their interaction.<\/jats:p>","DOI":"10.3390\/ijms21155475","type":"journal-article","created":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T06:16:47Z","timestamp":1596435407000},"page":"5475","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":121,"title":["SARS-CoV-2 and the Nervous System: From Clinical Features to Molecular Mechanisms"],"prefix":"10.3390","volume":"21","author":[{"given":"Manuela","family":"Pennisi","sequence":"first","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia, 97\u201395123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5659-662X","authenticated-orcid":false,"given":"Giuseppe","family":"Lanza","sequence":"additional","affiliation":[{"name":"Department of Surgery and Medical-Surgical Specialties, University of Catania, Via Santa Sofia, 78\u201395123 Catania, Italy"},{"name":"Oasi Research Institute\u2013IRCCS, Via Conte Ruggero, 73\u201394018 Troina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Falzone","sequence":"additional","affiliation":[{"name":"Epidemiology Unit, IRCCS Istituto Nazionale Tumori \u201cFondazione G. Pascale\u201d, Via Mariano Semmola, 53 \u201380131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1579-8807","authenticated-orcid":false,"given":"Francesco","family":"Fisicaro","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia, 97\u201395123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6937-3065","authenticated-orcid":false,"given":"Raffaele","family":"Ferri","sequence":"additional","affiliation":[{"name":"Oasi Research Institute\u2013IRCCS, Via Conte Ruggero, 73\u201394018 Troina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8332-6863","authenticated-orcid":false,"given":"Rita","family":"Bella","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Via Santa Sofia, 87\u201395123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,31]]},"reference":[{"key":"ref_1","first-page":"4030","article-title":"Mechanisms of host defense following severe acute respiratory syndrome-coronavirus (SARS-CoV) pulmonary infection of mice","volume":"173","author":"Glass","year":"2004","journal-title":"J. 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