Neurological Involvements of SARS-CoV2 Infection
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Neurological Involvements of SARS-CoV2 Infection Amin Gasmi 1 & Torsak Tippairote 2,3 & Pavan Kumar Mujawdiya 4 & Asma Gasmi Benahmed 5 & Alain Menzel 6 & Maryam Dadar 7 & Geir Bjørklund 8 Received: 11 May 2020 / Accepted: 11 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract COVID-19 is a pandemic viral infection caused by a novel coronavirus, SARS-CoV2, which is a global concern of the twentyfirst century for its rapid spreading in a short period. Apart from its known acute respiratory involvements, the CNS manifestations of COVID-19 are common. These neurological symptoms are diverse and could range from mild nonspecific or specific symptoms such as the loss of various sensory perceptions, the worrying autoimmune Guillain–Barré syndrome, to the lifethreatening acute disseminated encephalomyelitis, and the CNS-mediated respiratory distress. An autopsy report documented the presence of SARS-CoV2 in brain tissues of a COVID-19 patient. However, there is no definite conclusion on the mechanisms of SARS-CoV2 neuroinvasion. These proposed mechanisms include the direct viral invasion, the systemic blood circulation, or the distribution of infected immune cells. Concerning these different neuropathophysiologies, COVID-19 patients who are presenting with either the early-onset, multiple, and severe CNS symptoms or rapid respiratory deterioration should be suspected for the direct viral neuroinvasion, and appropriate management options should be considered. This article reviews the neurological manifestations, the proposed neuroinvasive mechanisms, and the potential neurological sequelae of SARS-CoV2. Keywords COVID-19 . SARS-CoV2 . Neuroinvasion . Severe acute respiratory syndrome . Angiotensin-converting enzyme 2 receptor
Introduction The pandemics of COVID-19 affect global citizens and drastically alter our living norms. The causative virus for the disease is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), a positive-stranded RNA virus that belongs to the Coronaviridae family [1]. Other known coronaviruses in * Geir Bjørklund [email protected] 1
Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée, Villeurbanne, France
2
Thailand Institute for Functional Medicine, Bangkok, Thailand
3
Healing Passion Medical Center, Bangkok, Thailand
4
Birla Institute of Technology and Science –Pilani, Hyderabad, India
5
Académie Internationale de Médecine Dentaire Intégrative, Paris, France
6
Laboratoires Réunis, Junglinster, Luxembourg
7
Agricultural Research, Education and Extension Organization (AREEO), Razi Vaccine and Serum Research Institute, Karaj, Iran
8
Council for Nutritional and Environmental Medicine (CONEM), Toften 24, 8610 Mo i Rana, Norway
this family are the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), which cause severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS), respectively [2, 3]. Major clinical manifestations of
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