Demyelination as a result of an immune response in patients with COVID-19

Abstract

The coronavirus disease of 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus-2 (SARS CoV-2), that already appeared as a global pandemic. Presentation of the disease often includes upper respiratory symptoms like dry cough, dyspnea, chest pain, and rhinorrhea that can develop to respiratory failure, needing intubation. Furthermore, the occurrence of acute and subacute neurological manifestations such as stroke, encephalitis, headache, and seizures are frequently stated in patients with COVID-19. One of the reported neurological complications of severe COVID-19 is the demolition of the myelin sheath. Indeed, the complex immunological dysfunction provides a substrate for the development of demyelination. Nevertheless, few published reports in the literature describe demyelination in subjects with COVID-19. In this short narrative review, we discuss probable pathological mechanisms that may trigger demyelination in patients with SARS‐CoV‐2 infection and summarize the clinical evidence, confirming SARS-CoV-2 condition as a risk factor for the destruction of myelin.

Vitamin B12 and D deficiency as cofactors of COVID-19 vaccine-induced chronic neurological adverse reactions: Two cases and a hypothesis

“…Further, PASC (long COVID) often presents with similar neurological symptomatology to our two cases (Proal & VanElzakker, 2021;Shabani, 2021). Indeed, one small study of older adults hospitalised with COVID-19 found favourable outcomes when patients were administered combined vitamin D (1000 IU), magnesium (150 mg), and vitamin B12 (500 µg) (Tan et al, 2020).…”

“…Myalgic Encephalomyelitis, chronic Lyme disease). Indeed, SARS-CoV-2 infection has been reported to cause neurological problems including demyelination (Zanin et al, 2020) via multiple mechanisms including host inflammatory response and autoimmunity (Shabani, 2021).…”

An overview of the neurological aspects in COVID-19 infection

“…In other words the brain and spine Magnetic resonance imaging (MRI) of the patient exhibited a new onset of multiple, non-enhancing demyelinating lesions. It was assumed that following SARS-CoV-2 infection, the pro-inflammatory environment induced by the cytokine storm might be responsible for the activation of glial cells with subsequent demyelination as reported by ( Mehta et al, 2020 , Shabani, 2021 ). As a para-infective or post-infective phenomenon, the virus could trigger the activation of antibodies against the glial cells ( Zanin et al, 2020 ).…”

Acute Cerebellar Inflammation and Related Ataxia: Mechanisms and Pathophysiology

“…COVID-19 infection caused by SARS-CoV-2 is now considered a risk factor of demyelination of the CNS, as well as the peripheral nervous system [125]. Several cases have already been presented for acute demyelination after COVID-19 infection [126][127][128][129].…”