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Neurological manifestations of the coronavirus (SARS-CoV-2) pandemic 2019–2020
  1. Kaiming Liu1,
  2. Mengxiong Pan2,
  3. Zheman Xiao3,
  4. Xiaopei Xu4
  1. 1 Department of Neurology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
  2. 2 Department of Neurology, First People's Hospital of Huzhou, Huzhou, China
  3. 3 Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China
  4. 4 Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China
  1. Correspondence to Dr Xiaopei Xu, Department of Radiology, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China; xiaopeix{at}

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Since December 2019, a cluster of cases with contact history of live animals in Huanan seafood wholesale market of Wuhan city developed an unexplained course of pneumonia. A novel virus was identified and named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Later on, WHO declared that the outbreak constitutes a Public Health Emergency of International Concern and named the disease COVID-19. As of 6 April 2020, more than 1 270 000 human infections with the novel coronavirus have been confirmed in more than 200 countries or regions with nearly 70 000 reported deaths. Studies revealed that angiotensin-converting enzyme 2 (ACE2) is the main host cell receptor of SARS-CoV-2.1 Since ACE2 is expressed in the neurons and glial cells, COVID-19 may also cause neurological symptoms. Considering the neurological manifestations of COVID-19 have been rarely mentioned in past literature,2 familiarising neurologists with the clinical course of the disease is critical in treating and controlling the disease.

Infectious agent and clinical features

The coronavirus known as SARS-CoV-2 is a novel beta coronavirus in the form of RNA and has nearly 29 000 nucleotide base pairs that hold the genetic code for viral production. SARS-CoV-2 is transmitted mainly through respiratory tract secretions or by direct contact. Asymptomatic persons are also potential sources of SARS-CoV-2 infection. Based on the current epidemiological investigations, the …

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