Neurological Complications and Pathophysiological Pathways of the Novel Coronavirus Sars-Cov-2: A Systematic Review Publisher



Naderi M ; Ghiyasi Z ; Farjami P ; Yarahmadi D ; Bashiri Goodarzi S ; Aboutalebi M ; Parnianfard N
Source: Future Virology Published:2025

Abstract

Aims: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the virus responsible for Coronavirus Disease 2019 (COVID-19), has been increasingly recognized for its neurological disorders. This systematic review aimed to synthesize current evidence on the spectrum of neurological complications associated with SARS-CoV-2 infection and the pathophysiological mechanisms. Materials and methods: A search of scientific literature was performed across databases including Web of Science, PubMed, and Scopus from 2019 to 2025. The quality of included studies was assessed using AMSTAR 2 for systematic reviews, JBI Checklist for case reports, and NOS for cohort and case-control studies. Results: The findings demonstrated that SARS-CoV-2 caused neurological symptoms in the Central Nervous System (CNS) and Peripheral Nervous System (PNS). The involvement of CNS included encephalitis, stroke, encephalopathy, myelitis, neuroinflammation, and demyelinating disorders. The PNS disorders such as Guillain–Barre syndrome (GBS), peripheral neuropathy, anosmia, and ageusia, were also frequently observed. Autonomic dysfunction and musculoskeletal complications like myositis were reported. The pathophysiological mechanisms included direct viral neuroinvasion, disruption of the blood–brain barrier, immune-mediated responses, and systemic inflammation. Conclusions: SARS-CoV-2 revealed neurotropic potential and can impact the nervous system through multifaceted mechanisms. Neurological involvement is both common and clinically significant, often correlating with disease severity and poorer outcomes. © 2025 Informa UK Limited, trading as Taylor & Francis Group.