Although SARS-CoV-2 is most often regarded as a respiratory virus, acute infection can also affect many different organ systems, including the brain, resulting in a wide range of neurological complications with long-lasting impacts. In a Perspective, Serena Spudich and Avindra Nath discuss the neurological symptoms that accompany COVID-19 and the possible mechanisms that cause them. “With millions of individuals affected, nervous system complications pose public health challenges for rehabilitation and recovery and for disruptions in the workforce due to loss of functional capacity,” write Spudich and Nath. “There is an urgent need to understand the pathophysiology of these disorders and develop disease-modifying therapies.” As the pandemic continues, the neurological complications of COVID-19 are becoming more prominent. They can include confusion, stroke, neuromuscular disorders, depression, sensory disturbances and even psychosis, many of which persist months after infection. What’s more, some evidence suggests that COVID-19 infection may trigger future development of neurodegenerative diseases such as Alzheimer’s or Parkinson’s. However, little is known about the physiopathology of these symptoms. Spudich and Nath discuss the possible mechanisms that give rise to these neurological symptoms, which may include vascular and immune dysfunction like non-specific neuroinflammation and anti-neural autoimmune dysregulation, and possible viral infection in the central nervous system. According to the authors, cases of neurological “Long Covid” symptoms may result from the emergence and persistence of these mechanisms.