Does COVID‐19 contribute to development of neurological disease?

Abstract

Background Although coronavirus disease 2019 (COVID‐19) has been associated primarily with pneumonia, recent data show that the causative agent of COVID‐19, the coronavirus severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), can infect a large number of vital organs beyond the lungs, such as the heart, kidneys, and the brain. Thus, there is evidence showing possible retrograde transmission of the virus from the olfactory epithelium to regions of the brain stem. Methods This is a literature review article. The research design method is an evidence‐based rapid review. The present discourse aim is first to scrutinize and assess the available literature on COVID‐19 repercussion on the central nervous system (CNS). Standard literature and database searches were implemented, gathered relevant material, and extracted information was then assessed. Results The angiotensin‐converting enzyme 2 (ACE2) receptors being the receptor for the virus, the threat to the central nervous system is expected. Neurons and glial cells express ACE2 receptors in the CNS, and recent studies suggest that activated glial cells contribute to neuroinflammation and the devastating effects of SARS‐CoV‐2 infection on the CNS. The SARS‐CoV‐2‐induced immune‐mediated demyelinating disease, cerebrovascular damage, neurodegeneration, and depression are some of the neurological complications discussed here. Conclusion This review correlates present clinical manifestations of COVID‐19 patients with possible neurological consequences in the future, thus preparing healthcare providers for possible future consequences of COVID‐19.

Molecular Mechanisms of Palmitic Acid Augmentation in COVID-19 Pathologies

“…Besides respiratory and gastrointestinal tracts, there is accumulating evidence that SARS-CoV-2 has a tropism for the nervous system, leading to neurological sequelae including immune-mediated demyelinating disease, cerebrovascular damage, and neurodegeneration [54][55][56]. SARS-CoV-2 may infect neurons, microglia, astrocytes, pericytes/endothelial cells, ependymocytes/choroid epithelial cells, and neural stem/progenitor cells [57,58].…”

“…While the mechanisms by which SARS-CoV-2 impairs the CNS are not completely known, neuroinflammation and blood-brain barrier (BBB) disruption have been suggested to contribute to neurological symptoms and poor prognosis [60][61][62]. Indeed, profound neuroinflammatory changes have been reported in COVID-19 patients [63], which could be due to direct infection of the CNS, microglia activation, and activated peripheral immune response to SARS-CoV-2 infection [56,64], all of which could be worsened by obesity [65,66]. Significant peripheral inflammation during COVID-19 could disrupt the BBB and contribute to COVID-19 neuropathologies [67].…”

The co-circulation of two infectious diseases and the impact of vaccination against one of them

“…In the model, disease-1 can emulate the role of, for instance, measles or even COVID-19. In fact, COVID-19, in addition to causing respiratory problems, cerebrovascular disorders, neurological injuries, and psychological distress ( Mahalakshmi et al., 2021 ), can also suppress host immunity ( Remy et al., 2020 ), which can increase the vulnerability to future infections as measles does. In the model, disease-2 can be any non-vaccine preventable infection, such as hepatitis C, or a vaccine-preventable infection, but with poor adherence to vaccination, such as hepatitis A ( Johnson et al., 2019 ).…”

Drug repurposing of selective serotonin reuptake inhibitors: Could these drugs help fight COVID-19 and save lives?

“…It has also been reported that viral infections can trigger brain endothelial and epithelial cells to produce cytokines that impair neuronal firing in the hippocampus, leading to depressive-like symptoms [51]. Summarizing the clinical symptoms reported in SARS virus infection, there is thus the possibility that SARS virus infection affected mood by altering the 5-HT system [52]. Therefore, 5-HTR-targeting drugs could be considered as a potential approach in therapies being developed for treating anxiety and depression induced by the COVID-19 infection.…”