Potential neurological effects of severe COVID-19 infection

Abstract

Coronaviruses (CoVs) are large positive stranded enveloped RNA viruses that generally cause enteric and respiratory diseases in humans and in animals. Most human CoVs have recently attracted global attention to their lethal potential and great infectious capacity. A highly pathogenic CoV, called COVID-19 or SARS-CoV-2, dramatically emerged in December 2019 in Wuhan, China. This new CoV has caused severe pneumonia in China and rapidly spreads around the world, the COVID-19 pandemic. Growing evidence pieces show that viruses, such as CoVs, can enter the central nervous system from different pathways and inducing neurotoxicity. Therefore, it is urgent to make clear whether SARS-CoV-2 has access to the central nervous system and can cause direct neuronal effects. Moreover, a brain-lung-brain axis is been proposed from the scientific community where severe neurological dysfunction and injury are associated with lung injury, and vice versa. In this axis, virus-induced inflammation and oxidative stress could be the common mechanisms responsible for CoV neurological symptoms. Therefore, is important to make clear whether SARS-CoV-2 lung damage can cause direct or indirect neuronal effects.

Characteristics and Outcomes of Individuals With Pre-existing Kidney Disease and COVID-19 Admitted to Intensive Care Units in the United States

“…Dialysis patients have unique neurologic vulnerability related to vascular disease and dialysis treatment-induced ischemia and osmolar shifts that may leave them susceptible to both the direct (ie, neuroinvasion) and indirect (ie, oxidative stress, hypoxia, and ischemia) neurologic effects of severe COVID-19. 42,43 In addition, a lower percentage of patients with pre-existing kidney disease (regardless of whether treated by dialysis) reported respiratory symptoms (shortness of breath and cough) and fever compared with patients without kidney disease. These findings are consistent with existing reports 23,37 and highlight the necessity of vigilance for nontraditional COVID-19 symptoms such as altered mental status and gastrointestinal symptoms.…”

“…oxidative stress, hypoxia, and ischemia) neurological effects of severe COVID-19. 42 , 43 In addition, a lower percentage of patients with pre-existing kidney disease (dialysis-dependent and CKD) reported respiratory symptoms (shortness of breath and cough) and fever compared to patients without kidney disease. These findings are consistent with existing reports 23 , 37 and highlight the necessity of vigilance for non-traditional COVID-19 symptoms such as altered mental status and gastrointestinal symptoms.…”

COVID-19 vaccines: The status and perspectives in delivery points of view

“…While a few countries have considered slow and intentional exposure, akin to chicken pox parties from the 1980’s, this would need to be done safely without overburdening hospitals and would take years [ 95 ]. Additionally, SARS-CoV-2 is much more deadly than the chicken pox or influenza viruses and has shown to cause long-lasting effects on the lungs, the heart, and the central nervous system, which are still not fully understood [ 197 ]. A vaccine is desperately needed not only for individual healthcare but also to achieve herd immunity, in which at least 70% of the total population would need to be vaccinated [ 198 ].…”

Hesperidin and SARS-CoV-2: New Light on the Healthy Function of Citrus Fruits

“…The internalization of SARS-CoV-2 is mediated by the binding of the spike glycoprotein of the virus with its receptor (ACE2) on the cell membranes. ACE2 is expressed in several tissues, including alveolar lung cells, gastrointestinal tissue, and even the brain [7][8][9][10]. The viral particle is internalized in a vesicle, whose envelope is then removed, allowing the genomic RNA to be released into the cytoplasm.…”