COVID-19: dealing with a potential risk factor for chronic neurological disorders

Abstract

SARS-CoV2 infection is responsible for a complex clinical syndrome, named Coronavirus Disease 2019 (COVID-19), whose main consequences are severe pneumonia and acute respiratory distress syndrome. Occurrence of acute and subacute neurological manifestations (encephalitis, stroke, headache, seizures, Guillain-Barrè syndrome) is increasingly reported in patients with COVID-19. Moreover, SARS-CoV2 immunopathology and tissue colonization in the gut and the central nervous system, and the systemic inflammatory response during COVID-19 may potentially trigger chronic autoimmune and neurodegenerative disorders. Specifically, Parkinson's disease, multiple sclerosis and narcolepsy present several pathogenic mechanisms that can be hypothetically initiated by SARS-CoV2 infection in susceptible individuals. In this short narrative review, we summarize the clinical evidence supporting the rationale for investigating SARS-CoV2 infection as risk factor for these neurological disorders, and suggest the opportunity to perform in the future SARS-CoV2 serology when diagnosing these disorders.

COVID-19 sequelae in adults aged less than 50 years: A systematic review

“…Radiologically, there seem to be distinct changes in cerebral micro-structure, especially in those areas related to memory and smell loss, compared to healthy controls [ 29 ]. However, there is widespread speculation concerning neurological long-term consequences [ 38 , [44] , [45] , [46] ]. Several authors speculate that SARS-CoV-2 might trigger neurodegenerative diseases like multiple sclerosis, Parkinson’s disease and narcolepsy in predisposed individuals in the long-term [ [44] , [45] , [46] ].…”

“…However, there is widespread speculation concerning neurological long-term consequences [ 38 , [44] , [45] , [46] ]. Several authors speculate that SARS-CoV-2 might trigger neurodegenerative diseases like multiple sclerosis, Parkinson’s disease and narcolepsy in predisposed individuals in the long-term [ [44] , [45] , [46] ]. The occurrence of anosmia and ageusia in some patients has even been associated with prodromal features of Parkinson’s disease [ 44 ].…”

CNS implications of COVID-19: a comprehensive review

“…This increase in the inflammatory profile is interesting since enhanced levels of C-reactive protein, IL-1β, IL-2, IL-6 and TNF are also observed in the blood samples of the patients suffering from Parkinsonism (Qin et al 2016;Qiu et al 2019), besides, demonstrating high degree of correlation with the clinical severity (Maass et al 2019). It is being speculated that the neurological complications in which inflammation plays a crucial role, such as multiple sclerosis, narcolepsy, Alzheimer's Disorder etc., could show high degree of association with the COVID-19 (Schirinzi et al 2020). Evidence generated so far suggest that the psychiatric comorbidity of COVID-19 cannot be neglected.…”

Friedreich ataxia in COVID-19 time: current impact and future possibilities

“…Definitely many factors might have contributed, including psychological vulnerability and the altered structure of life around them; however, as it occurred in other conditions [ 4 – 6 ], the weight of regular physiotherapy and physical activities’ interruption can not be underestimated. In fact, physical training is critical for global health of FA patients [ 2 ], conditioning positively either personal abilities or quality of life [ 7 – 9 ].…”