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2.
Mol Neurobiol ; 58(9): 4694-4715, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1281328

ABSTRACT

The unremitting coronavirus disease 2019 (COVID-19) pandemic caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) marked a year-long phase of public health adversaries and has severely compromised healthcare globally. Early evidence of COVID-19 noted its impact on the pulmonary and cardiovascular functions, while multiple studies in recent time shed light on its substantial neurological complications, though a comprehensive understanding of the cause(s), the mechanism(s), and their neuropathological outcomes is scarce. In the present review, we conferred evidence of neurological complications in COVID-19 patients and shed light on the SARS-CoV-2 infection routes including the hematogenous, direct/neuronal, lymphatic tissue or cerebrospinal fluid, or infiltration through infected immune cells, while the underlying mechanism of SARS-CoV-2 invasion to the central nervous system (CNS) was also discussed. In an up-to-date manner, we further reviewed the impact of COVID-19 in developing diverse neurologic manifestations associated with CNS, peripheral nervous system (PNS), skeletal muscle, and also pre-existing neurological diseases, including Alzheimer's disease, Parkinson's disease, multiple sclerosis, epilepsy, and myasthenia gravis. Furthermore, we discussed the involvement of key factors including age, sex, comorbidity, and disease severity in exacerbating the neurologic manifestations in COVID-19 patients. An outlook of present therapeutic strategies and state of existing challenges in COVID-19 management was also accessed. Conclusively, the present report provides a comprehensive review of COVID-19-related neurological complications and emphasizes the need for their early clinical management in the ongoing COVID-19 pandemic.


Subject(s)
COVID-19/complications , Nervous System Diseases/etiology , Pandemics , SARS-CoV-2/pathogenicity , Adult , Age Factors , Aged , Aged, 80 and over , Autoimmune Diseases of the Nervous System/epidemiology , Autoimmune Diseases of the Nervous System/etiology , COVID-19/epidemiology , COVID-19/immunology , COVID-19/virology , Central Nervous System/virology , Child , Comorbidity , Female , Humans , Immune System/virology , Inflammation , Male , Middle Aged , Models, Biological , Muscular Diseases/etiology , Nervous System Diseases/drug therapy , Nervous System Diseases/epidemiology , Nervous System Diseases/physiopathology , Neurodegenerative Diseases/complications , Neurons/virology , Organ Specificity , Sex Factors , Viremia/chemically induced , Viremia/immunology , Virus Internalization
3.
Crit Rev Immunol ; 40(6): 537-542, 2020.
Article in English | MEDLINE | ID: covidwho-1050522

ABSTRACT

The pandemic caused by the SARS-CoV-2 has made new treatments a goal for the scientific community. One of these treatments is Ivermectin. Here we discuss the hypothesis of dysbiosis caused by the use of Ivermectin and the possible impacts on neuroinflammatory diseases after the end of the pandemic.


Subject(s)
COVID-19/epidemiology , COVID-19/virology , Dysbiosis/epidemiology , SARS-CoV-2 , Autoimmune Diseases of the Nervous System/epidemiology , Autoimmune Diseases of the Nervous System/etiology , COVID-19/complications , COVID-19/drug therapy , Disease Susceptibility , Dysbiosis/etiology , Humans , Ivermectin/adverse effects , Ivermectin/therapeutic use , SARS-CoV-2/drug effects , SARS-CoV-2/immunology
4.
J Mol Neurosci ; 71(11): 2192-2209, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1037256

ABSTRACT

The coronavirus disease 2019 (COVID-19) pandemic is an issue of global significance that has taken the lives of many across the world. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for its pathogenesis. The pulmonary manifestations of COVID-19 have been well described in the literature. Initially, it was thought to be limited to the respiratory system; however, we now recognize that COVID-19 also affects several other organs, including the nervous system. Two similar human coronaviruses (CoV) that cause severe acute respiratory syndrome (SARS-CoV-1) and Middle East respiratory syndrome (MERS-CoV) are also known to cause disease in the nervous system. The neurological manifestations of SARS-CoV-2 infection are growing rapidly, as evidenced by several reports. There are several mechanisms responsible for such manifestations in the nervous system. For instance, post-infectious immune-mediated processes, direct virus infection of the central nervous system (CNS), and virus-induced hyperinflammatory and hypercoagulable states are commonly involved. Guillain-Barré syndrome (GBS) and its variants, dysfunction of taste and smell, and muscle injury are numerous examples of COVID-19 PNS (peripheral nervous system) disease. Likewise, hemorrhagic and ischemic stroke, encephalitis, meningitis, encephalopathy acute disseminated encephalomyelitis, endothelialitis, and venous sinus thrombosis are some instances of COVID-19 CNS disease. Due to multifactorial and complicated pathogenic mechanisms, COVID-19 poses a large-scale threat to the whole nervous system. A complete understanding of SARS-CoV-2 neurological impairments is still lacking, but our knowledge base is rapidly expanding. Therefore, we anticipate that this comprehensive review will provide valuable insights and facilitate the work of neuroscientists in unfolding different neurological dimensions of COVID-19 and other CoV associated abnormalities.


Subject(s)
COVID-19/complications , Nervous System Diseases/etiology , Pandemics , SARS-CoV-2/pathogenicity , Adolescent , Adult , Angiotensin-Converting Enzyme 2/physiology , Asymptomatic Infections , Autoimmune Diseases of the Nervous System/etiology , Blood-Brain Barrier , COVID-19/immunology , COVID-19/physiopathology , Cerebrovascular Disorders/etiology , Child , Communicable Diseases, Emerging , Coronavirus Infections/complications , Humans , Hypoxia/etiology , Hypoxia/physiopathology , Nervous System/virology , Nervous System Diseases/immunology , Nervous System Diseases/physiopathology , Organ Specificity , Receptors, Virus/physiology , Severe Acute Respiratory Syndrome/complications , Synapses/virology , Viral Tropism , Young Adult
5.
Neurol Sci ; 42(1): 35-38, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-910259

ABSTRACT

The 2019 new coronavirus (SARS-CoV-2) is a novel respiratory virus which has increasingly spread all over the world. Although the predominant clinical presentation is represented by respiratory symptoms, neurological manifestation of SARS-CoV-2 is being increasingly recognized. In the present report, we present a case of post SARS-CoV-2 autoimmune encephalitis associated with a new-onset refractory status epilepticus (NORSE).


Subject(s)
Autoimmune Diseases of the Nervous System/etiology , COVID-19/complications , Encephalitis/etiology , Status Epilepticus/etiology , Aged, 80 and over , Autoimmune Diseases of the Nervous System/diagnosis , Electroencephalography , Encephalitis/diagnosis , Humans , Male , Status Epilepticus/diagnosis
6.
Neurol Neuroimmunol Neuroinflamm ; 7(5)2020 09.
Article in English | MEDLINE | ID: covidwho-810332

ABSTRACT

OBJECTIVE: To present the COVID-19-associated GBS, the prototypic viral-triggered autoimmune disease, in the context of other emerging COVID-19-triggered autoimmunities, and discuss potential concerns with ongoing neuroimmunotherapies. METHODS: Eleven GBS cases in four key COVID-19 hotspots are discussed regarding presenting symptoms, response to therapies and cross-reactivity of COVID spike proteins with nerve glycolipids. Emerging cases of COVID-19-triggered autoimmune necrotizing myositis (NAM) and encephalopathies are also reviewed in the context of viral invasion, autoimmunity and ongoing immunotherapies. RESULTS: Collective data indicate that in this pandemic any patient presenting with an acute paralytic disease-like GBS, encephalomyelitis or myositis-even without systemic symptoms, may represent the first manifestation of COVID-19. Anosmia, ageusia, other cranial neuropathies and lymphocytopenia are red flags enhancing early diagnostic suspicion. In Miller-Fisher Syndrome, ganglioside antibodies against GD1b, instead of QG1b, were found; because the COVID-19 spike protein also binds to sialic acid-containing glycoproteins for cell-entry and anti-GD1b antibodies typically cause ataxic neuropathy, cross-reactivity between COVID-19-bearing gangliosides and peripheral nerve glycolipids was addressed. Elevated Creatine Kinase (>10,000) is reported in 10% of COVID-19-infected patients; two such patients presented with painful muscle weakness responding to IVIg indicating that COVID-19-triggered NAM is an overlooked entity. Cases of acute necrotizing brainstem encephalitis, cranial neuropathies with leptomeningeal enhancement, and tumefactive postgadolinium-enhanced demyelinating lesions are now emerging with the need to explore neuroinvasion and autoimmunity. Concerns for modifications-if any-of chronic immunotherapies with steroids, mycophenolate, azathioprine, IVIg, and anti-B-cell agents were addressed; the role of complement in innate immunity to viral responses and anti-complement therapeutics (i.e. eculizumab) were reviewed. CONCLUSIONS: Emerging data indicate that COVID-19 can trigger not only GBS but other autoimmune neurological diseases necessitating vigilance for early diagnosis and therapy initiation. Although COVID-19 infection, like most other viruses, can potentially worsen patients with pre-existing autoimmunity, there is no evidence that patients with autoimmune neurological diseases stable on common immunotherapies are facing increased risks of infection.


Subject(s)
Betacoronavirus , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Guillain-Barre Syndrome/diagnosis , Guillain-Barre Syndrome/etiology , Myositis/diagnosis , Myositis/etiology , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Aged , Aged, 80 and over , Autoimmune Diseases of the Nervous System/diagnosis , Autoimmune Diseases of the Nervous System/etiology , Autoimmune Diseases of the Nervous System/immunology , Betacoronavirus/immunology , COVID-19 , Coronavirus Infections/immunology , Female , Guillain-Barre Syndrome/immunology , Humans , Male , Myositis/immunology , Pandemics , Pneumonia, Viral/immunology , SARS-CoV-2
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