COVID-19 Pandemic: A Neurological Perspective
Abstract
Even though severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily affects the respiratory system, the nervous system is not spared either. SARS-CoV-2 has been isolated from the brain, olfactory bulb and cerebrospinal fluid. During the SARS (SARS-CoV-1) outbreak in 2002 to 2003, neurons had been found to be highly susceptible for infection and the virus could cause extensive neuronal damage. Similar to SARS-CoV-1,
SARS-CoV-2 exploits the angiotensin-converting enzyme 2 (ACE-2) receptor to gain entry and infect both glial and neuronal cells which express ACE-2 receptors.[1] SARS-CoV-2 affects the central as well as peripheral nervous system presenting with diverse manifestations like myelitis, cerebrovascular events (CVE) and encephalitis to mention a few.[2,3] Indepth understanding of neurotropic potential of this virus will be helpful to individualize the treatment protocol from a neurological perspective.
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References
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054-62. DOI: https://doi.org/10.1016/s0140-6736(20)30566-3
Nath A. Neurological complications of corona virus infection. Neurology. 2020;94(19):809- 810. PMID: 32229625 DOI: https://doi.org/10.1212/WNL.0000000000009455
Filatov A, Sharma P, Hindi F, Espinosa PS. Neurological complications of corona virus diseases (COVID-19). Cureus. 2020;12:e7352. PMID: 32328364 DOI: https://doi.org/10.7759/cureus.7352
Mahase E. Covid-19: WHO declares pandemic because of “alarming levels” of spread, severity, and inaction. BMJ 2020;368:m1036. PMID: 32165426 DOI: https://doi.org/10.1136/bmj.m1036
MOHP. Nepal; 2020 May 10. Available from: https://covid19.mohp.gov.np/
Su S, Wong G, Shi W, Liu J, Lai ACK, Zhou J et al. Epidemiology, genetic recombination, and pathogenesis of coronaviruses. Trends Microbiol. 2016;24:490-502. PMID: 27012512 DOI: https://doi.org/10.1016/j.tim.2016.03.003
Wrapp D, Wang N, Corbett KS, Goldsmith JA, Hsieh CL, Abiona O et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science. 2020;367(6483):1260‐63.PMID: 32075877 DOI: https://doi.org/10.1126/science.abb2507
Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host−Virus Interaction, and Proposed Neurotropic Mechanisms. ACS Chem Neurosci. 2020;11:995-8. PMID: 32167747 DOI: https://doi.org/10.1021/acschemneuro.0c00122.
Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol. 2008;82(15);7264-75. PMID: 18495771 DOI: https://doi.org/10.1128/JVI.00737-08
Harberts E, Yao K, Wohler JE, Maric D, Ohayon J, Henkin R et al. Human herpesvirus-6 entry into CNS through the olfactory pathway. Proc Natl Acad Sci USA. 2011;108(33):13734-9. PMID: 21825120 DOI: https://doi.org/10.1073/pnas.1105143108
Butowt R, Bilinska K. SARS-CoV-2: Olfaction, Brain Infection, and the Urgent Need for Clinical Samples Allowing Earlier Virus Detection. ACS Chem Neurosci. 2020;11(9):1200-03. PMID: 32283006 DOI: https://doi.org/10.1021/acschemneuro.0c00172
Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV-2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol; 2020; Epub Feb 27 2020. PMID: 32104915 DOI: https://doi.org/10.1002/jmv.25728
Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020;S0889-1591(20)30357-3. [Epub ahead of print]. PMID: 32240762 DOI: https://doi.org/10.1016/j.bbi.2020.03.031
Poyiadji N, Shahin G, Noujaim D, Stone M, Patel S, Griffith B. COVID-19-associated acute hemorrhagic necrotizing encephalopathy: CT and MRI features. Radiology. 2020; Epub March 31 2020. DOI: https://doi.org/10.1148/radiol.2020201187
Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020;e201127 [Epub ahead of print]. PMID: 32275288 DOI: https://doi.org/10.1001/jamaneurol.2020.1127
Lahiri D. Ardila A. Neuro perspective: COVID-19 pandemic: A Neurological Perspective. Cureus. 2020; 12(4):e7889. DOI: https://doi.org/10.7759/cureus.7889
Zhao H, Shen D, Zhou H, Liu J, Chen S. Guillain Barre syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol. 2020;19:383-4. PMID: 32246917 DOI: https://doi.org/10.1016/S1474-4422(20)30109- 5.
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