NEUROLOGICAL COMPLICATIONS OF COVID-19: FROM ACUTE ENCEPHALOPATHY TO LONG-TERM COGNITIVE IMPAIRMENT

Abstract

Background: The SARS-CoV-2 virus exerts profound effects on the central and peripheral nervous system, producing a spectrum of neurological manifestations ranging from mild headache and anosmia to life-threatening encephalitis, stroke, and Guillain-Barre syndrome. Long-term neurological sequelae — including cognitive impairment, mood disorders, and autonomic dysfunction — constitute a major component of Post-Acute Sequelae of SARS CoV-2 (PASC). Objective: This review examines the mechanisms, clinical spectrum, diagnostic approach, and management of COVID-19 neurological complications. Methods: Narrative review of neurological COVID-19 literature from PubMed, Neurology, JAMA Neurology, and Lancet Neurology, 2020–2024. Results: Neurological manifestations occur in 36–85% of hospitalized COVID-19 patients. Key mechanisms include neuroinflammation, cerebrovascular injury, direct viral neuroinvasion, and autoimmune processes. Long-term cognitive sequelae affect millions globally. Conclusion: Neurologists, internists, and rehabilitation specialists must be equipped to recognize and manage COVID-19 neurological complications, and research into targeted neuroprotective therapies is urgently needed.