Unraveling the Possible Routes of SARS-COV-2 Invasion into the Central Nervous System
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Reflections from the COVID Pandemic (A Iranzo and M Rosenfeld, Section Editors)
Unraveling the Possible Routes of SARS-COV-2 Invasion into the Central Nervous System Maria Lima, MD1 Vasileios Siokas, MD, PhD1 Athina-Maria Aloizou, MD1 Ioannis Liampas, MD, MSc1 Alexios-Fotios A. Mentis, MD, PhD, PMC, MPH1,2 Zisis Tsouris, MD, MSc1 Anastasios Papadimitriou, MD1 Panayiotis D. Mitsias, MD, PhD3,4,5 Aristidis Tsatsakis, PhD, DSc6 Dimitrios P. Bogdanos, MBA, MD, PhD7 Stavros J. Baloyannis, MD, PhD8 Efthimios Dardiotis, MD, PhD1,* Address *,1 Department of Neurology, Laboratory of Neurogenetics, University of Thessaly, University Hospital of Larissa, Larissa, Greece Email: [email protected] 2 Public Health Laboratories, Hellenic Pasteur Institute, Athens, Greece 3 Department of Neurology, School of Medicine, University of Crete, 71003, Heraklion, Greece 4 Department of Neurology, Henry Ford Hospital, Detroit, MI, 48202, USA 5 School of Medicine, Wayne State University, Detroit, MI, 48202, USA 6 Laboratory of Toxicology, School of Medicine, University of Crete, 71003, Heraklion, Greece 7 Department of Rheumatology and clinical Immunology, University General Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece 8 Research Institute for Alzheimer’s Disease, Aristotelian University of Thessaloniki, Thessaloniki, Greece * Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Reflections from the COVID Pandemic
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Curr Treat Options Neurol
(2020) 22:37
Keywords SARS-CoV-2 I SARS-2 I COVID-19 I Pandemic I Neuroinvasion I CNS penetration I Neurological manifestations I Coronaviruses (CoVs) I Neurotropism I Neurovirulence
Abstract Purpose of Review To describe the possible neuroinvasion pathways of Severe Acute Respiratory Syndrome-related Coronavirus-2 (SARS-CoV-2), the virus responsible for the Coronavirus disease-19 (Covid-19) pandemic. Recent Findings We present data regarding the family of Coronaviruses (CoVs) and the central nervous system (CNS), and describe parallels between SARS-CoV-2 and other members of the family, which have been investigated in more depth and combine these findings with the recent advancements regarding SARS-CoV-2. Summary SARS-CoV-2 like other CoVs is neuroinvasive, neurotropic and neurovirulent. Two main pathways of CNS penetration seem to be the strongest candidates, the hematogenous and the neuronal. Τhe olfactory route in particular appears to play a significant role in neuroinvasion of coronaviruses and SARS-CoV-2, as well. However, existing data suggest that other routes, involving the nasal epithelium in general, lymphatic tissue and the CSF may also play roles in SARS-CoV-2 invasion into the CNS.
Introduction Coronaviruses (CoVs) are a large family of viruses, capable of infecting many species of birds and mammals [1–3]. There are seven coronaviruses known to infect humans, called human coronaviruses (HCoVs) [4–6]. Clinically, infection with a coronavirus
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