Manifestations neurologiques dans la pandémie de COVID-19

Five major categories of COVID-19 related neurological disorders emerged: encephalopathies, often with agitation, delirium and psychosis. Their physiopathology is probably mixed (general sepsis-induced inflammation, hypoxemia, renal failure, hypercoagulability, direct viral aggression); dysimmune CNS disorders (acute disseminated encephalomyelitis, more rarely Miller–Fisher syndrome, acute haemorrhagic necrotic encephalitis…); ischaemic strokes associated with a prothrombotic state: COVID-19 appears to be an independant risk factor of stroke; Guillain–Barré syndrome; various cranial nerves or peripheral nerves injuries. Anosmia, which is a key symptom, is most often the consequence of the olfactive epithelial insult, but may sometimes be due to the extension of viral aggression to the olfactive nerve and cortex. Prevention, early recognition and management of COVID-19-related neurological disorders are challenging and require a better understanding of their physiopathology.