After three years of the COVID-19 pandemic, we have learned many aspects of the disease and the virus: its molecular structure, how it infects human cells, the clinical picture at different ages, potential therapies, and the effectiveness of prophylaxis. Research is currently focused on the short- and long-term consequences of COVID-19. We review the available information on the neurodevelopmental outcome of infants born during the pandemic from infected and non-infected mothers, as well as the neurological impact of neonatal SARS-CoV-2 infection. We also discuss the mechanisms that could potentially affect the fetal or neonatal brain including direct impact after vertical transmission, maternal immune activation with a proinflammatory cytokine storm, and finally the consequences of complications of pregnancy secondary to maternal infection that could affect the fetus. Several follow-up studies have noted a variety of neurodevelopmental sequelae among infants born during the pandemic. There is controversy as to the exact etiopathogenesis of these neurodevelopmental effects: from the infection itself or as a result of parental emotional stress during that period. We summarize case reports of acute neonatal SARS-CoV-2 infections associated with neurological signs and neuroimaging changes. Many infants born during previous pandemics caused by other respiratory viruses demonstrated serious neurodevelopmental and psychological sequelae that were only recognized after several years of follow-up. It is essential to warn health authorities about the need for very long-term continuous follow up of infants born during the SARS-CoV-2 pandemic for early detection and treatment that could help mitigate the neurodevelopmental consequences of perinatal COVID-19.

在 COVID-19 大流行三年之后，我们了解了这种疾病和病毒的许多方面：它的分子结构、它如何感染人体细胞、不同年龄段的临床表现、潜在疗法以及预防的有效性。目前的研究重点是 COVID-19 的短期和长期后果。我们回顾了有关受感染和未受感染母亲在大流行期间所生婴儿神经发育结果的可用信息，以及新生儿 SARS-CoV-2 感染对神经系统的影响。我们还讨论了可能影响胎儿或新生儿大脑的机制，包括垂直传播后的直接影响、母体免疫激活与促炎细胞因子风暴、最后，继发于可能影响胎儿的母体感染的妊娠并发症的后果。几项后续研究注意到大流行期间出生的婴儿存在各种神经发育后遗症。关于这些神经发育影响的确切发病机制存在争议：来自感染本身或由于该时期父母的情绪压力。我们总结了与神经体征和神经影像学改变相关的急性新生儿 SARS-CoV-2 感染的病例报告。许多在之前由其他呼吸道病毒引起的大流行期间出生的婴儿表现出严重的神经发育和心理后遗症，这些后遗症只有在几年的随访后才被发现。