Hydroelectrolytic Disorder in COVID-19 patients: Evidence Supporting the Involvement of Subfornical Organ and Paraventricular Nucleus of the Hypothalamus

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:124

Review

de Melo, Igor Santana¹  Sabino-Silva, Robinson²  Cunha, Thulio Marquez³  Goulart, Luiz Ricardo⁴  Reis, Wagner Luis⁵  Gomes Jardim, Ana Carolina⁶  Shetty, Ashok K.⁷  de Castro, Olagide Wagner¹ 

[1] Fed Univ Alagoas UFAL, Inst Biol Sci & Hlth, Dept Physiol, Maceio, Alagoas, Brazil

[2] Fed Univ Uberlandia UFU, Inst Biomed Sci, Dept Physiol, Uberlandia, MG, Brazil

[3] Univ Fed Uberlandia, Sch Med, Dept Pulmonol, Uberlandia, MG, Brazil

[4] Univ Fed Uberlandia, Inst Biotechnol, Uberlandia, MG, Brazil

[5] Fed Univ Santa Catarina UFSC Florianopolis, Dept Physiol, Sci Biol Sci Ctr, Florianopolis, SC, Brazil

[6] Univ Fed Uberlandia, Inst Biomed Sci, Lab Virol, Uberlandia, MG, Brazil

[7] Texas A&M Univ, Inst Regenerat Med, Dept Mol & Cellular Med, Coll Med, College Stn, TX 77843 USA

关键词: SARS-CoV-2;    COVID-19;    Brain;    Neuroinvasion;    Hydroelectrolyte balance;    Hypokalemia;   

DOI  :  10.1016/j.neubiorev.2021.02.008

来源: Elsevier

【 摘 要 】

Multiple neurological problems have been reported in coronavirus disease-2019 (COVID-19) patients because severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) likely spreads to the central nervous system (CNS) via olfactory nerves or through the subarachnoid space along olfactory nerves into the brain?s cerebrospinal fluid and then into the brain?s interstitial space. We hypothesize that SARS-CoV-2 enters the subfornical organ (SFO) through the above routes and the circulating blood since circumventricular organs (CVOs) such as the SFO lack the blood-brain barrier, and infection of the SFO causes dysfunction of the hypothalamic paraventricular nucleus (PVN) and supraoptic nucleus (SON), leading to hydroelectrolytic disorder. SARS-CoV-2 can readily enter SFO-PVN-SON neurons because these neurons express angiotensin-converting enzyme-2 receptors and proteolytic viral activators, which likely leads to neurodegeneration or neuroinflammation in these regions. Considering the pivotal role of SFO-PVN-SON circuitry in modulating hydroelectrolyte balance, SARS-CoV-2 infection in these regions could disrupt the neuroendocrine control of hydromineral homeostasis. This review proposes mechanisms by which SARS-CoV-2 infection of the SFO-PVN-SON pathway leads to hydroelectrolytic disorder in COVID-19 patients.

【 授权许可】

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