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SARS-CoV-2 and the Nervous System: From Clinical Features to Molecular Mechanisms
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Journal Article
SARS-CoV-2 and the Nervous System: From Clinical Features to Molecular Mechanisms
2020
Overview
Increasing evidence suggests that Severe Acute Respiratory Syndrome-coronavirus-2 (SARS-CoV-2) can also invade the central nervous system (CNS). However, findings available on its neurological manifestations and their pathogenic mechanisms have not yet been systematically addressed. A literature search on neurological complications reported in patients with COVID-19 until June 2020 produced a total of 23 studies. Overall, these papers report that patients may exhibit a wide range of neurological manifestations, including encephalopathy, encephalitis, seizures, cerebrovascular events, acute polyneuropathy, headache, hypogeusia, and hyposmia, as well as some non-specific symptoms. Whether these features can be an indirect and unspecific consequence of the pulmonary disease or a generalized inflammatory state on the CNS remains to be determined; also, they may rather reflect direct SARS-CoV-2-related neuronal damage. Hematogenous versus transsynaptic propagation, the role of the angiotensin II converting enzyme receptor-2, the spread across the blood-brain barrier, the impact of the hyperimmune response (the so-called “cytokine storm”), and the possibility of virus persistence within some CNS resident cells are still debated. The different levels and severity of neurotropism and neurovirulence in patients with COVID-19 might be explained by a combination of viral and host factors and by their interaction.
Publisher
MDPI AG,MDPI
Subject
Angiotensin-Converting Enzyme 2
/ Animals
/ Betacoronavirus - isolation & purification
/ Betacoronavirus - physiology
/ Blood-Brain Barrier - metabolism
/ Blood-Brain Barrier - virology
/ Brain Diseases - complications
/ Central Nervous System - metabolism
/ Central Nervous System - virology
/ Coronavirus Infections - pathology
/ Coronavirus Infections - virology
/ COVID-19
/ Encephalitis - complications
/ Enzymes
/ Genomes
/ Humans
/ Middle East respiratory syndrome
/ Peptidyl-Dipeptidase A - metabolism
/ Pneumonia, Viral - pathology
/ Review
/ Severe acute respiratory syndrome coronavirus 2
/ Vaccines
/ Viruses
