To review neuroanatomical and neurophysiological changes and resulting complications in COVID-19-infected patients.

The infectious disease coronavirus (CoV), initially discovered on November 17, 2019, in Wuhan, China, was the cause of the global calamity in 2020. Although COVID-19 symptoms were initially reported as respiratory symptoms, neurological manifestations are now increasingly recognized, which were suspected to occur through direct or indirect involvement of the peripheral or central nervous system and brain parenchyma.

Aiming to our research question about neuroanatomical and neurophysiological changes in COVID-19 infected patients, an extensive literature review was done from Dec 2019 to Feb 2023 using the search terms. The snowballing method was used in retrieving more potentially relevant articles. Articles were analyzed based on the manuscript's title and body search items. Only observational studies, research studies, case reports, and series  published in  English-language were considered through Google Scholar, PubMed, medRvix, UpToDate, and Scopus. To include the non-indexed journals relevant to our research question, a hand search was conducted through the Google search engine, and we gathered 11 articles in return.

Based on relevance, a literature search yielded 35 articles out of 1564 on post-COVID-19 neurological changes in our review analysis. Reduced grey matter and higher mean diffusivity, microhemorrhages at the olfactory lobe, and bulb resulted in olfactory dysfunction. Neuromuscular disorders (33.7%), cerebrovascular diseases (CVDs) (27.3%), acute encephalopathy (19.4%), and seizures (7.8%) were the complications reported. Interestingly, cognitive impairment ranging from brain fog to the acceleration of Alzheimer’s disease is also described in patients with acute COVID-19.

The literature review emphasizes the variability in the neuroanatomical and neurophysiological manifestations observed in post-COVID-19 patients, ranging from being healthy to having comorbidities. For successful medical intervention, it is incredibly crucial to understand these profoundly impacting the brain, even though precise mechanisms affecting the brain are yet to be established.