Neurological manifestations and comorbidity associated with COVID-19: an overview
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COVID-19
Neurological manifestations and comorbidity associated with COVID-19: an overview Mukesh Kumar 1,2 & Ajit Kumar Thakur 1 Received: 21 August 2020 / Accepted: 10 October 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract First in 2002, severe acute respiratory syndrome coronavirus (SARS-CoV), second in 2012, Middle East respiratory syndrome coronavirus (MERS-CoV), and now the third in the December 2019, emergence of tremendously pathogenic and large-scale epidemic novel coronavirus (SARS-CoV-2) has brought the worst conditions into the human inhabitants of the twenty-first century. The SARS-CoV-2 uses the resembling receptor, angiotensin-converting enzyme 2 (ACE2) as that for SARS-CoV, and mainly feasts through the respiratory tract. The ACE2 receptor appearances have been also detected upon glial cells and neurons, which makes them a potential target of SARS-CoV-2 disease (COVID-19). Consequently, cells expressing ACE2, apart from lung and cardiovascular tissue, neurons and glial cells may act as targets and are thus vulnerable to SARS-CoV-2 systemic infection as well as its central nervous system (CNS) comorbidities. Investigation of the neurological manifestations of COVID-19 is a step towards better understanding the SARS-CoV-2 infections, inhibiting the additional spread and treating patients affected by this pandemic. In this concern, more clinical examinations for CNS involvement of SARS-CoV-2 are warranted. In this article, we have reviewed the neurological characteristic features of COVID-19 patients, latent neurotropic mechanisms of SARS-CoV-2 involvement in the comorbidity associated with CNS disorders, and neurological manifestations associated with COVID-19. Therefore, in the perspective of COVID-19 pandemic, clinicians and healthcare workers should be aware of a wide spectrum of neurological manifestations associated with COVID-19 along with their signs and symptoms for initial diagnosis and isolation of the patients. Keywords SARS-CoV-2 . COVID-19 . Angiotensin-converting enzyme 2 . Comorbidities . Neurological manifestations
Introduction One of the most contagious viruses is coronavirus (Family: Coronaviridae), primarily targeting the human respiratory system and infecting the epithelial cells of the respiratory tract, but it also has neuroinvasive capabilities to spread from the respiratory tract to the central nervous system (CNS) [1, 2]. Earlier epidemics or pandemics of coronaviruses comprise the severe acute respiratory syndrome (SARS-CoV) during 2002 and Middle East respiratory syndrome (MERS-CoV) during
* Ajit Kumar Thakur [email protected] 1
Neuropharmacology Research Laboratory, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi 110 017, India
2
Indian Pharmacopoeia Commission, Ministry of Health & Family Welfare, Government of India, Ghaziabad, Uttar Pradesh 201 002, India
2012 [3, 4]. The present pandemic is an acute respiratory disease, caused by a novel coronavirus (SARS-CoV-2, earlier known as 2019-nCoV
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