Systemic review of CNS involvement and its manifestations in SARS-CoV2 positive patients

Abstract

Coronavirus is known to cause various systemic infections both in human and animal which are mostly mild in nature. However, recent years have seen major pandemics caused by coronavirus which are very invasive and virulent in nature. The recent SARS-CoV2 is a new addition to this list of coronavirus pandemics. So the present study was done to systematically review the CNS involvement and its manifestations in SARS-CoV2 positive patients. Systemic review of article published between 1st Dec 2019 to 31st July 2020 searched through web-based database of MEDLINE (Pubmed) and Google scholar using following keywords “COVID -19” OR “CORONAVIRUS” OR “SARS-CoV2” AND “NEUROLOGICAL” OR “CNS” OR “BRAIN”. Using the steps of systemic review eight article were selected for qualitative analysis. Majority of these article were reporting neurological symptoms among patients admitted in different wards along with others general symptoms. None of the study was specifically devoted to study the neurological manifestations and complications in SARS-CoV2 positive patients. The present study concludes that there is a scarcity of good quality research which attempts to establish the role of SARS-CoV2 infection in CNS and its manifestations. However, there are evidences that CNS involvement is present in majority of the patients. Proper documentation of theses involvement and indentification of these into mild, moderate and severe infection will help in early identification and treatment of these patients

microRNA Heterogeneity, Innate-Immune Defense and the Efficacy of SARS-CoV-2 Infection—A Commentary

“…A type of sncRNA sometimes referred to as interfering RNA (iRNA) has long been known to have evolved in plants, invertebrates, and vertebrates as an antiviral mechanism, combating viral infections through the rapid degradation of invading ssvRNA by binding to viral nucleic acid sequences to inhibit viral replication and host cell infection [ 33 , 35 , 36 , 37 , 38 , 39 ]. A human host’s natural and unique complement of miRNAs, sncRNAs, mRNAs, and other small RNA and/or DNA sequences appears to contribute to the observed natural quantity, complexity, and variability of nucleic acids located within host cells, and hence, their individual susceptibility to viral infection [ 11 , 12 , 13 , 14 , 32 ].…”

“…A human host’s natural and unique complement of miRNAs, sncRNAs, mRNAs, and other small RNA and/or DNA sequences appears to contribute to the observed natural quantity, complexity, and variability of nucleic acids located within host cells, and hence, their individual susceptibility to viral infection [ 11 , 12 , 13 , 14 , 32 ]. More specifically, the targeting and inactivation of SARS-CoV-2 by natural and/or pre-existing miRNAs or sncRNAs: (i) Would provide a natural protective mechanism or ssRNA-based innate-immune type of ‘ host immunity ’ against SARS-CoV-2 invasion, replication and COVID-19 [ 36 , 37 ]; (ii) would help explain individual variability of innate-immunity and resistance to SARS-CoV-2 infection of some persons who naturally express sncRNAs or miRNAs antisense to SARS-CoV-2, or other miRNAs or ssRNAs that target pathological ssRNA viruses [ 36 , 37 , 38 , 39 , 40 ]; (iii) suggests that very specific artificially synthesized and chemically stabilized sncRNA and/or miRNAs may be of therapeutic value in the accelerated destabilization, depolymerization, and destruction of the invading SARS-CoV-2 viral RNA sequence itself, resulting in SARS-CoV-2 degradation and the rapid cessation and termination of SARS-CoV-2 pathogenic activity; (iv) may also be useful in the targeting and inactivation of other contagious and invasive viruses, including neurotrophic viruses, that possess ssRNA genomes; and (v) would present a series of useful biomarkers to assess the absence or specific stage of SARS-CoV-2 infection and the efficacy of anti-SARS-CoV-2 pharmaceutical intervention and treatment strategies [ 31 , 39 ].…”

“…Overall these findings: (i) Provide insight into miRNA-mediated natural immunity via a prospective SARS-CoV-2 sense-miRNA-antisense interaction and host sncRNA-mediated regulatory mechanisms that are highly selective and protective against viral pathogens possessing an ssRNA genome; and (ii) illustrates the potential and novel use of host miRNAs or engineered, stabilized miRNAs as protective agents against SARS-CoV-2 invasion that may be useful in blocking ssvRNA viral replication in humans, and/or serve as sncRNA-based therapeutics against or biomarkers for SARS-CoV-2 infection [ 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ].…”

Manifestações Neurológicas Em Pacientes Que Contraíram Covid-19: Uma Revisão Integrativa Da Literatura

“…Apontam-se como possíveis mecanismos de neuroinvasão a disseminação hematogênica ou via neuronal, a qual é relacionada à encefalite viral. Postula-se que tal mecanismo seria possibilitado pela ligação do SARS-CoV-2 aos receptores expressos na superfície neuronal 23,24 .…”

“…Por sua vez, as lesões decorrentes da hipóxia cerebral -mais comuns na segunda semana da doença -estão associadas à vasodilatação e edema cerebral, de forma que relacionam-se com o surgimento de cefaléia e tontura. Ademais, a diminuição do aporte de oxigênio ao tecido cerebral pode ainda contribuir para a resposta imunomediada, a qual aumenta a resposta pró-inflamatória e gera a denominada "tempestade de citocinas", predispondo acidentes cerebrovasculares 23,24 .…”