The nervous system damage in COVID-19

Based on the available publications, the article systematizes the data on the forms of damage to the central nervous system in СOVID-19 patients. We discuss the diagnostic approaches (laboratory, instrumental and radiological) and the therapeutic tactics for different nosological forms from cranial mononeuropathies to acute inflammatory Guillain-Barr polyneuropathy and severe damage to the brain and spinal cord with acute hemorrhagic necrotizing encephalopathy and myelopathies. Pathogenetically, neurological disorders in COVID-19 can be caused by a cytokine storm, hypoxemia, homeostasis disorders (encephalopathy of critical illness), neurotropic and neurovirulence features of SARS-CoV-2 (isolated damage to the cranial nerves, focal and diffuse lesions of the central nervous system), and mixed effects of these factors. COVID-19 affects the course of chronic neurological diseases, especially related with neuroimmune disorders. All of the above determines the need for a multidisciplinary approach to the treatment of COVID-19 and its complications with the mandatory participation of a neurologist.