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Shortly after its outbreak, coronavirus disease 2019 (COVID-19) has very rapidly spread to become a global epidemic. Early clinical findings mainly included typical symptoms such as fever and cough with a very high transmission rate. Recent findings have demonstrated neurological manifestations of atypical symptoms, which is associated with poor prognosis. In this paper, we describe the neurological aspects of COVID-19 pneumonia in terms of relevant neurons, virus-associated receptors, and olfactory and neurological clinical manifestations and offer insights on treatment.


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Advances in the study of nervous system infections in COVID-19

Show Author's information Chao He1,§Ling He2,§Lin Chen3,( )Wei Wang4,( )
Department of Neurosurgery, Zhuji Affiliated Hospital of Shaoxing University, Shaoxing 300800, Zhejiang, China
Darwin Cell Biotechnology Co., Ltd., Beijing 100124, China
Department of Neurosurgery, Center for Brain Diseases, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 100700, China
Department of Intensive Care Unit, Zhuji Affiliated Hospital of Wenzhou Medical University, Wenzhou 300800, Zhejiang, China

§ These authors contributed equally to this work.

These authors contributed equally to this work.

Abstract

Shortly after its outbreak, coronavirus disease 2019 (COVID-19) has very rapidly spread to become a global epidemic. Early clinical findings mainly included typical symptoms such as fever and cough with a very high transmission rate. Recent findings have demonstrated neurological manifestations of atypical symptoms, which is associated with poor prognosis. In this paper, we describe the neurological aspects of COVID-19 pneumonia in terms of relevant neurons, virus-associated receptors, and olfactory and neurological clinical manifestations and offer insights on treatment.

Keywords: COVID-19, SARS-CoV-2, olfaction, nervous system

References(47)

[1]
Toljan K. Letter to the editor regarding the viewpoint “Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanism”. ACS Chem Neurosci 2020, 11(8): 1192-1194.
[2]
Li YC, Bai WZ, Hashikawa T. Response to Commentary on “The neuroinvasive potential of SARS-CoV-2 may play a role in the respiratory failure of COVID-19 patients”. J Med Virol 2020, 92(7): 707-709.
[3]
Mao L, Jin HJ, Wang MD, et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2020, 77(6):683-690.
[4]
Baig AM. Neurological manifestations in COVID-19 caused by SARS-CoV-2. CNS Neurosci Ther 2020, 26(5): 499-501.
[5]
Bertran Recasens B, Martinez-Llorens JM, Rodriguez-Sevilla JJ, et al. Lack of dyspnea in patients with COVID-19: another neurological conundrum? Eur J Neurol 2020, 27(9): e40.
[6]
Du YZ, Tu L, Zhu PJ, et al. Clinical features of 85 fatal cases of COVID-19 from Wuhan: A retrospective observational study. Am J Respir Crit Care Med 2020, 201(11): 1372-1379.
[7]
Desforges M, Le Coupanec A, Dubeau P, et al. Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system? Viruses 2019, 12(1): E14.
[8]
Bhatnagar T, Murhekar MV, Soneja M, et al. Lopinavir/ritonavir combination therapy amongst symptomatic coronavirus disease 2019 patients in India: Protocol for restricted public health emergency use. Indian J Med Res 2020, 151(2 & 3): 184-189.
[9]
Wang Q, Qiu Y, Li JY, et al. A unique protease cleavage site predicted in the spike protein of the novel pneumonia coronavirus (2019-nCoV) potentially related to viral transmissibility. Virol Sin 2020, 35(3): 337-339.
[10]
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): 1200-1203.
[11]
Desforges M, Le Coupanec A, Brison E, et al. Neuroinvasive and neurotropic human respiratory coronaviruses: potential neurovirulent agents in humans. Adv Exp Med Biol 2014, 807: 75-96.
[12]
Xie ZH, Chen L, Wang Y, et al. Comparison of different microsurgery methods for trigeminal neuralgia. Transl Neurosci Clin 2016, 2(3): 183-187.
[13]
Wu YS, Xu XL, Chen ZJ, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun 2020, 87: 18-22.
[14]
Kissler SM, Tedijanto C, Goldstein E, et al. Projecting the transmission dynamics of SARS- CoV-2 through the postpandemic period. Science 2020, 368(6493): 860-868.
[15]
Pan PY, Zhao HL, Zhang X, et al. Cyclophilin a signaling induces pericyte-associated blood-brain barrier disruption after subarachnoid hemorrhage. J Neuroinflammation 2020, 17(1): 16.
[16]
Pan PY, Qu J, Li Q, et al. Aggravated pulmonary injury after subarachnoid hemorrhage in PDGF-Bret/ret mice. Chin Neurosurg J 2020, 6: 13.
[17]
Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol 2020, 92(6): 552-555.
[18]
Turtle L. Respiratory failure alone does not suggest central nervous system invasion by SARS-CoV-2. J Med Virol 2020, 92(7): 705-706.
[19]
Gheblawi M, Wang K, Viveiros A, et al. Angiotensin converting enzyme 2: SARS-CoV-2 receptor and regulator of the renin-angiotensin system. Circ Res 2020, 126(10):1456-1474.
[20]
Hanff TC, Harhay MO, Brown TS, et al. Is there an association between COVID-19 mortality and the renin-angiotensin system? A call for epidemiologic investigations. Clin Infect Dis 2020, 71(15): 870-874.
[21]
Ortega JT, Serrano ML, Pujol FH, et al. Role of changes in SARS-CoV-2 spike protein in the interaction with the human ACE2 receptor: an in silico analysis. EXCLI J 2020, 19: 410-417.
[22]
Yen MY, Schwartz J, Chen SY, et al. Interrupting COVID-19 transmission by implementing enhanced traffic control bundling: Implications for global prevention and control efforts. J Microbiol Immunol Infect 2020, 53(3): 377-380.
[23]
Lukassen S, Chua RL, Trefzer T, et al. SARS-CoV-2 receptor ACE2 and TMPRSS2 are primarily expressed in bronchial transient secretory cells. EMBO J 2020, 39(10): e105114.
[24]
Shaikh AG, Mitoma H, Manto M. Cerebellar scholars’ challenging time in COVID-19 pandemia. Cerebellum 2020, 19(3): 343-344.
[25]
Paybast S, Emami A, Koosha M, et al. Novel coronavirus disease (COVID-19) and central nervous system complications: what neurologist need to know. Acta Neurol Taiwan 2020, 29(1): 24-31.
[26]
Wang HY, Li XL, Yan ZR, et al. Potential neurological symptoms of COVID-19. Ther Adv Neurol Disord 2020, 13: 175628642091783.
[27]
Lee Y, Min P, Lee S, et al. Prevalence and duration of acute loss of smell or taste in COVID-19 patients. J Korean Med Sci 2020, 35(18): e174.
[28]
Zhao Y, Zhao ZX, Wang YJ, et al. Single-cell RNA expression profiling of ACE2, the putative receptor of Wuhan 2019-nCov. bioRxiv 2020, .
[29]
Hjelmesæth J, Skaare D. Loss of smell or taste as the only symptom of COVID-19. Tidsskr Nor Laegeforen 2020, 140(7), .
[30]
Hopkins C, Surda P, Whitehead E, et al. Early recovery following new onset anosmia during the COVID-19 pandemic - an observational cohort study. J Otolaryngol Head Neck Surg 2020, 49(1): 26.
[31]
Nahama A, Ramachandran R, Cisternas AF, et al. The role of afferent pulmonary innervation in ARDS associated with COVID-19 and potential use of resiniferatoxin to improve prognosis: A review. Med Drug Discov 2020, 5: 100033.
[32]
Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of 2019 COVID-19 infection in China. medRxiv 2020, .
[33]
Yin R, Feng W, Wang T, et al. Concomitant neurological symptoms observed in a patient diagnosed with coronavirus disease 2019. J Med Virol 2020, 92(10): 1782-1784.
[34]
Cheng KB, Wei M, Shen H, et al. Clinical characteristics of 463 patients with common and severe type coronavirus disease (in Chinese). Shanghai Med J 2020. 43(4): 224-232.
[35]
Huang CL, Huang LX, Wang YM, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021, 397(10270): 220-232.
[36]
Gutiérrez-Ortiz C, Méndez-Guerrero A, Rodrigo-Rey S, et al. Miller Fisher syndrome and polyneuritis cranialis in COVID-19. Neurology 2020, 95(5): e601-e605.
[37]
Asadi-Pooya AA, Simani L. Central nervous system manifestations of COVID-19: a systematic review. J Neurol Sci 2020, 413: 116832.
[38]
Qiu F, Wu Y, Zhang AQ, et al. Changes of coagulation function and risk of stroke in patients with COVID-19. Brain Behav 2021, 11(6): e02185.
[39]
Yuen KCJ, Blevins LS Jr, Findling JW. Important management considerations in patients with pituitary disorders during the time of the covid-19 pandemic. Endocr Pract 2020, 26(8): 915-922.
[40]
Radmanesh F, Rodriguez-Pla A, Pincus MD, et al. Severe cerebral involvement in adult-onset hemophagocytic lymphohistiocytosis. J Clin Neurosci 2020, 76: 236-237.
[41]
Kim SW, Su KP. Using psychoneuroimmunity against COVID-19. Brain Behav Immun 2020, 87: 4-5.
[42]
Ahmed W, Khan A, Sundar WH, et al. Neurological diseases caused by coronavirus infection of the respiratory airways. Brain Sci Adv 2020, 6(4): 324-343.
[43]
Fernandez CE, Franz CK, Ko JH, et al. Imaging review of peripheral nerve injuries in patients with COVID-19. Radiology 2021, 298(3): E117-E130.
[44]
Corrêa DG, Hygino da Cruz LC Jr, Lopes FCR, et al. Magnetic resonance imaging features of COVID- 19-related cranial nerve lesions. J Neurovirol 2021, 27(1): 171-177.
[45]
Politi LS, Salsano E, Grimaldi M. Magnetic resonance imaging alteration of the brain in a patient with coronavirus disease 2019 (COVID-19) and anosmia. JAMA Neurol 2020, 77(8): 1028-1029.
[46]
Poyiadji N, Shahin G, Noujaim D, et al. COVID- 19-associated acute hemorrhagic necrotizing encephalopathy: imaging features. Radiology 2020, 296(2): E119-E120.
[47]
Hayashi M, Sahashi Y, Baba Y, et al. COVID- 19-associated mild encephalitis/encephalopathy with a reversible splenial lesion. J Neurol Sci 2020, 415: 116941.
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Publication history

Received: 24 March 2021
Revised: 15 June 2021
Accepted: 21 June 2021
Published: 08 December 2021
Issue date: September 2021

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© The authors 2021

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