4.6 Article

Neurological Manifestation of SARS-CoV-2 Induced Inflammation and Possible Therapeutic Strategies Against COVID-19

Journal

MOLECULAR NEUROBIOLOGY
Volume 58, Issue 7, Pages 3417-3434

Publisher

SPRINGER
DOI: 10.1007/s12035-021-02318-9

Keywords

COVID-19; Neuropathophysiology; Cytokine storm; Neurodegenerative disorders; Vaccine; Pandemic

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Funding

  1. Deanship of Scientific Research at Majmaah University

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The ongoing COVID-19 pandemic has been associated with extrapulmonary infections and manifestations, with a potential neurotropic effect of coronaviruses posing a risk to neuronal tissue. Neuronal symptoms like ageusia, anosmia, and neurological disorders have been reported in COVID-19 patients, highlighting the neurological impact of the disease. The interdependence between the brain, pulmonary organs, and systemic circulation may exacerbate the pathophysiological aspects of COVID-19, emphasizing the need for a holistic approach to treating patients with neurodegenerative or neuropsychological conditions. Vaccines are being developed as a top priority to combat the spread of the virus and address the neurological complications.
There are regular reports of extrapulmonary infections and manifestations related to the ongoing COVID-19 pandemic. Coronaviruses are potentially neurotropic, which renders neuronal tissue vulnerable to infection, especially in elderly individuals or in those with neuro-comorbid conditions. Complaints of ageusia, anosmia, myalgia, and headache; reports of diseases such as stroke, encephalopathy, seizure, and encephalitis; and loss of consciousness in patients with COVID-19 confirm the neuropathophysiological aspect of this disease. The brain is linked to pulmonary organs, physiologically through blood circulation, and functionally through the nervous system. The interdependence of these vital organs may further aggravate the pathophysiological aspects of COVID-19. The induction of a cytokine storm in systemic circulation can trigger a neuroinflammatory cascade, which can subsequently compromise the blood-brain barrier and activate microglia- and astrocyte-borne Toll-like receptors, thereby leading to neuronal tissue damage. Hence, a holistic approach should be adopted by healthcare professionals while treating COVID-19 patients with a history of neurodegenerative disorders, neuropsychological complications, or any other neuro-compromised conditions. Imperatively, vaccines are being developed at top priority to contain the spread of the severe acute respiratory syndrome coronavirus 2, and different vaccines are at different stages of development globally. This review discusses the concerns regarding the neuronal complications of COVID-19 and the possible mechanisms of amelioration.

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