Severe acute respiratory syndrome coronavirus 2 may be an underappreciated pathogen of the central nervous system

From National Research Council Canada

Download
  1. (PDF, 549 KB)
DOIResolve DOI: https://doi.org/10.1111/ene.14442
AuthorSearch for: 1ORCID identifier: https://orcid.org/0000-0003-3182-8903; Search for: 1; Search for: 1ORCID identifier: https://orcid.org/0000-0003-4741-9290; Search for: 2ORCID identifier: https://orcid.org/0000-0002-0065-1335
Name affiliation
  1. National Research Council of Canada. Nanotechnology
  2. National Research Council of Canada. Human Health Therapeutics
FormatText, Article
Journal titleEuropean Journal of Neurology
ISSN1351-5101
1468-1331
Article numberene.14442
Subjectblood-brain barrier; central nervous system; coronavirus; glia; neurogenic information; neuroinflammation; neurons; neurovascular unit
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) causes a highly contagious respiratory disease referred to as COVID‐19. However, emerging evidence indicates that a small but growing number of COVID‐19 patients also manifest neurological symptoms, suggesting that SARS‐CoV‐2 may infect the nervous system under some circumstances. SARS‐CoV‐2 primarily enters the body through the epithelial lining of the respiratory and gastrointestinal tracts, but under certain conditions this pleiotropic virus may also infect peripheral nerves and gain entry into the central nervous system (CNS). The brain is shielded by various anatomical and physiological barriers, most notably the blood–brain barrier (BBB) which functions to prevent harmful substances, including pathogens and pro‐inflammatory mediators, from entering the brain. The BBB is composed of highly specialized endothelial cells, pericytes, mast cells and astrocytes that form the neurovascular unit, which regulates BBB permeability and maintains the integrity of the CNS. In this review, potential routes of viral entry and the possible mechanisms utilized by SARS‐CoV‐2 to penetrate the CNS, either by disrupting the BBB or infecting the peripheral nerves and using the neuronal network to initiate neuroinflammation, are briefly discussed. Furthermore, the long‐term effects of SARS‐CoV‐2 infection on the brain and in the progression of neurodegenerative diseases known to be associated with other human coronaviruses are considered. Although the mechanisms of SARS‐CoV‐2 entry into the CNS and neurovirulence are currently unknown, the potential pathways described here might pave the way for future research in this area and enable the development of better therapeutic strategies.
Publication date
LanguageEnglish
Peer reviewedYes
Export citationExport as RIS
Report a correctionReport a correction
Record identifier76763d18-2bb6-4f0d-80fb-efa4b2e4d619
Record created2020-09-18
Record modified2020-09-18
Report a problem on this page
Date modified: