Current opinion in neurological manifestations of SARS-CoV-2 infection


ENGİN A. B. , ENGİN E. D. , ENGİN A.

CURRENT OPINION IN TOXICOLOGY, vol.25, pp.49-56, 2021 (Peer-Reviewed Journal) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 25
  • Publication Date: 2021
  • Doi Number: 10.1016/j.cotox.2021.03.004
  • Journal Name: CURRENT OPINION IN TOXICOLOGY
  • Journal Indexes: Emerging Sources Citation Index, Scopus
  • Page Numbers: pp.49-56
  • Keywords: COVID-19, Blood-brain barrier, ACE2, Thromboembolic complications, IL-6, Neuropilin-1, MITOCHONDRIAL DYSFUNCTION, BRAIN, RECEPTOR, DISEASE, ACE2, EXCITOTOXICITY, EXPRESSION, ANG-(1-7), COVID-19

Abstract

Neurological symptoms occur in approximately one-third of hospitalized patients with coronavirus disease 2019 (COVID-19). Among these symptoms, hypoxic encephalopathy develops in one-fifth of severe cases, while ischemic strokes due to thrombotic complications are common in one-third of COVID-19 intensive care patients. Brain involvement of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) is eventuated by several routes, including hematogenous spread, transsynaptic entry through infected neurons, olfactory nerve, ocular epithelium, vascular endothelium, and impaired blood- brain barrier. Besides the high angiotensin-converting enzyme-2 (ACE2) binding affinity, and FURIN preactivation, SARS-CoV-2 maintains efficient neuronal entry while evading immune surveillance by using basigin and neuropilin-1 receptors. However, the neurological manifestations and their pathogenic mechanisms are still debated in COVID-19 patients.