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Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms.
J Neurol. 2020 Aug; 267(8):2179-2184.JN

Abstract

Coronavirus disease 2019 (COVID-19), a disease caused by the novel betacoronavirus (SARS-CoV-2), has become a global pandemic threat. The potential involvement of COVID-19 in central nervous system (CNS) has attracted considerable attention due to neurological manifestations presented throughout the disease process. In addition, SARS-CoV-2 is structurally similar to SARS-CoV, and both bind to the angiotensin-converting enzyme 2 (ACE2) receptor to enter human cells. Thus, cells expressing ACE2, such as neurons and glial cells may act as targets and are thus vulnerable to SARS-CoV-2 infection. Here, we have reviewed the neurological characteristics of COVID-19 and summarized possible mechanisms of SARS-CoV-2 invasion of the CNS. COVID-19 patients have presented with a number of different neurological symptoms such as headache, dizziness, hyposmia, and hypogeusia during the course of illness. It has also been reported recently that some cases of COVID-19 have presented with concurrent acute cerebrovascular disease (acute ischemic stroke, cerebral venous sinus thrombosis, cerebral hemorrhage, subarachnoid hemorrhage), meningitis/encephalitis, acute necrotizing hemorrhagic encephalopathy, and acute Guillain-Barré syndrome. Furthermore, SARS-CoV-2 RNA detected in a cerebrospinal fluid specimen of a patient with COVID-19 have provided direct evidence to support the theory of neurotropic involvement of SARS-CoV-2. However, the underlying neurotropic mechanisms of SARS-CoV-2 are yet to be established. SARS-CoV-2 may affect CNS through two direct mechanisms (hematogenous dissemination or neuronal retrograde dissemination) or via indirect routes. The underlying mechanisms require further elucidation in the future.

Authors+Show Affiliations

Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.Department of Anesthesiology and Pain Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, People's Republic of China.Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan, Hubei, People's Republic of China. zhaoxu96@163.com.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32458193

Citation

Zhou, Zhiqiang, et al. "Understanding the Neurotropic Characteristics of SARS-CoV-2: From Neurological Manifestations of COVID-19 to Potential Neurotropic Mechanisms." Journal of Neurology, vol. 267, no. 8, 2020, pp. 2179-2184.
Zhou Z, Kang H, Li S, et al. Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms. J Neurol. 2020;267(8):2179-2184.
Zhou, Z., Kang, H., Li, S., & Zhao, X. (2020). Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms. Journal of Neurology, 267(8), 2179-2184. https://doi.org/10.1007/s00415-020-09929-7
Zhou Z, et al. Understanding the Neurotropic Characteristics of SARS-CoV-2: From Neurological Manifestations of COVID-19 to Potential Neurotropic Mechanisms. J Neurol. 2020;267(8):2179-2184. PubMed PMID: 32458193.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms. AU - Zhou,Zhiqiang, AU - Kang,Huicong, AU - Li,Shiyong, AU - Zhao,Xu, Y1 - 2020/05/26/ PY - 2020/04/15/received PY - 2020/05/16/accepted PY - 2020/05/14/revised PY - 2020/5/28/pubmed PY - 2020/7/23/medline PY - 2020/5/28/entrez KW - ACE2 KW - COVID-19 KW - Neurotropic KW - SARS-CoV-2 SP - 2179 EP - 2184 JF - Journal of neurology JO - J Neurol VL - 267 IS - 8 N2 - Coronavirus disease 2019 (COVID-19), a disease caused by the novel betacoronavirus (SARS-CoV-2), has become a global pandemic threat. The potential involvement of COVID-19 in central nervous system (CNS) has attracted considerable attention due to neurological manifestations presented throughout the disease process. In addition, SARS-CoV-2 is structurally similar to SARS-CoV, and both bind to the angiotensin-converting enzyme 2 (ACE2) receptor to enter human cells. Thus, cells expressing ACE2, such as neurons and glial cells may act as targets and are thus vulnerable to SARS-CoV-2 infection. Here, we have reviewed the neurological characteristics of COVID-19 and summarized possible mechanisms of SARS-CoV-2 invasion of the CNS. COVID-19 patients have presented with a number of different neurological symptoms such as headache, dizziness, hyposmia, and hypogeusia during the course of illness. It has also been reported recently that some cases of COVID-19 have presented with concurrent acute cerebrovascular disease (acute ischemic stroke, cerebral venous sinus thrombosis, cerebral hemorrhage, subarachnoid hemorrhage), meningitis/encephalitis, acute necrotizing hemorrhagic encephalopathy, and acute Guillain-Barré syndrome. Furthermore, SARS-CoV-2 RNA detected in a cerebrospinal fluid specimen of a patient with COVID-19 have provided direct evidence to support the theory of neurotropic involvement of SARS-CoV-2. However, the underlying neurotropic mechanisms of SARS-CoV-2 are yet to be established. SARS-CoV-2 may affect CNS through two direct mechanisms (hematogenous dissemination or neuronal retrograde dissemination) or via indirect routes. The underlying mechanisms require further elucidation in the future. SN - 1432-1459 UR - https://www.unboundmedicine.com/medline/citation/32458193/Understanding_the_neurotropic_characteristics_of_SARS_CoV_2:_from_neurological_manifestations_of_COVID_19_to_potential_neurotropic_mechanisms_ L2 - https://dx.doi.org/10.1007/s00415-020-09929-7 DB - PRIME DP - Unbound Medicine ER -