Neurological manifestations of SARS-CoV-2: complexity, mechanism and associated disorders

European Journal of Medical Research

Review

Sumeet Kapoor¹  Pradeep Kumar Jaiswal²  Prachi Rai³  Kritika Tyagi³  Harjeet Kaur³  Ravi Pratap Barnwal³  Anuj Gautam³  Akanksha Sharma⁴  Ashish Suttee⁵  Gurpal Singh⁶ 

[1] Centre for Biomedical Engineering, Indian Institute of Technology, New Delhi, India;Department of Biochemistry and Biophysics, Texas A & M University, 77843, College Station, TX, USA;Department of Biophysics, Panjab University, Chandigarh, India;Department of Biophysics, Panjab University, Chandigarh, India;University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India;School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, India;University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India;

关键词: SARS-CoV-2;    COVID;    Blood–brain barrier;    Central nervous system;    Neuroinvasion;    ACE-2;    Cerebrovascular disease;   

DOI  :  10.1186/s40001-023-01293-2

 received in 2023-03-22, accepted in 2023-08-16,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundCoronaviruses such as Severe Acute Respiratory Syndrome coronavirus (SARS), Middle Eastern Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) are associated with critical illnesses, including severe respiratory disorders. SARS-CoV-2 is the causative agent of the deadly COVID-19 illness, which has spread globally as a pandemic. SARS-CoV-2 may enter the human body through olfactory lobes and interact with the angiotensin-converting enzyme2 (ACE2) receptor, further facilitating cell binding and entry into the cells. Reports have shown that the virus can pass through the blood–brain barrier (BBB) and enter the central nervous system (CNS), resulting in various disorders. Cell entry by SARS-CoV-2 largely relies on TMPRSS2 and cathepsin L, which activate S protein. TMPRSS2 is found on the cell surface of respiratory, gastrointestinal and urogenital epithelium, while cathepsin-L is a part of endosomes.AimThe current review aims to provide information on how SARS-CoV-2 infection affects brain function.. Furthermore, CNS disorders associated with SARS-CoV-2 infection, including ischemic stroke, cerebral venous thrombosis, Guillain–Barré syndrome, multiple sclerosis, meningitis, and encephalitis, are discussed. The many probable mechanisms and paths involved in developing cerebrovascular problems in COVID patients are thoroughly detailed.Main bodyThere have been reports that the SARS-CoV-2 virus can cross the blood–brain barrier (BBB) and enter the central nervous system (CNS), where it could cause a various illnesses. Patients suffering from COVID-19 experience a range of neurological complications, including sleep disorders, viral encephalitis, headaches, dysgeusia, and cognitive impairment. The presence of SARS-CoV-2 in the cerebrospinal fluid (CSF) of COVID-19 patients has been reported. Health experts also reported its presence in cortical neurons and human brain organoids. The possible mechanism of virus infiltration into the brain can be neurotropic, direct infiltration and cytokine storm-based pathways. The olfactory lobes could also be the primary pathway for the entrance of SARS-CoV-2 into the brain.ConclusionsSARS-CoV-2 can lead to neurological complications, such as cerebrovascular manifestations, motor movement complications, and cognitive decline. COVID-19 infection can result in cerebrovascular symptoms and diseases, such as strokes and thrombosis. The virus can affect the neural system, disrupt cognitive function and cause neurological disorders. To combat the epidemic, it is crucial to repurpose drugs currently in use quickly and develop novel therapeutics.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

【 图 表 】

Fig. 2

Fig. 1

Fig. 3

Fig. 2

Fig. 2

12888_2023_5113_Article_IEq2.gif

40517_2023_261_Article_IEq3.gif