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ACS Chem Neurosci ; 11(14): 2048-2050, 2020 07 15.
Article in English | MEDLINE | ID: covidwho-627315


In COVID-19, lung manifestations present as a slowly evolving pneumonia with insidious early onset interstitial pulmonary edema that undergoes acute exacerbation in the late stages and microvascular thrombosis. Currently, these manifestations are considered to be only consequences of pulmonary SARS-CoV-2 virus infection. We are proposing a new hypothesis that neurogenic insult may also play a major role in the pathogenesis of these manifestations. SARS-CoV-2 mediated inflammation of the nucleus tractus solitarius (NTS) may play a role in the acute exacerbation of pulmonary edema and microvascular clotting in COVID-19 patients.

Coronavirus Infections/physiopathology , Hypotension/physiopathology , Lung/blood supply , Microvessels/physiopathology , Pneumonia, Viral/physiopathology , Pulmonary Edema/physiopathology , Solitary Nucleus/physiopathology , Thrombosis/physiopathology , Betacoronavirus , COVID-19 , Capillary Permeability/physiology , Coronavirus Infections/immunology , Cytokine Release Syndrome/immunology , Cytokine Release Syndrome/physiopathology , Facial Nerve , Glossopharyngeal Nerve , Humans , Inflammation , Lung/immunology , Microvessels/immunology , Pandemics , Parasympathetic Nervous System/physiopathology , Pneumonia, Viral/immunology , Pulmonary Edema/immunology , SARS-CoV-2 , Solitary Nucleus/immunology , Vagus Nerve , Vasoconstriction
ACS Chem Neurosci ; 11(13): 1865-1867, 2020 07 01.
Article in English | MEDLINE | ID: covidwho-595686


Many COVID-19 patients are presenting with atypical clinical features. Happy hypoxemia with almost normal breathing, anosmia in the absence of rhinitis or nasal obstruction, and ageusia are some of the reported atypical clinical findings. Based on the clinical manifestations of the disease, we are proposing a new hypothesis that SARS-CoV-2 mediated inflammation of the nucleus tractus solitarius may be the reason for happy hypoxemia in COVID-19 patients.

Betacoronavirus , Coronavirus Infections/physiopathology , Hypoxia/physiopathology , Pneumonia, Viral/physiopathology , Solitary Nucleus/physiopathology , Solitary Nucleus/virology , COVID-19 , Coronavirus Infections/complications , Cranial Nerves/physiopathology , Cranial Nerves/virology , Humans , Hypoxia/etiology , Inflammation/etiology , Inflammation/physiopathology , Inflammation/virology , Pandemics , Pneumonia, Viral/complications , SARS-CoV-2
ACS Chem Neurosci ; 11(11): 1520-1522, 2020 06 03.
Article in English | MEDLINE | ID: covidwho-324525


Accumulating data have now shown strong evidence that COVID-19 infection leads to the occurrence of neurological signs with different injury severity. Anosmia and agueusia are now well documented and included in the criteria list for diagnosis, and specialists have stressed that doctors screen COVID-19 patients for these two signs. The eventual brainstem dysregulation, due to the invasion of SARS CoV-2, as a cause of respiratory problems linked to COVID-19, has also been extensively discussed. All these findings lead to an implication of the central nervous system in the pathophysiology of COVID-19. Here we provide additional elements that could explain other described signs like appetite loss, vomiting, and nausea. For this, we investigated the role of brainstem structures located in the medulla oblongata involved in food intake and vomiting control. We also discussed the possible pathways the virus uses to reach the brainstem, i.e., neurotropic and hematogenous (with its two variants) routes.

Anorexia/physiopathology , Appetite Regulation/physiology , Autonomic Nervous System/physiopathology , Coronavirus Infections/physiopathology , Eating/physiology , Nausea/physiopathology , Pneumonia, Viral/physiopathology , Solitary Nucleus/physiopathology , Vomiting/physiopathology , Ageusia/etiology , Anorexia/etiology , Area Postrema/physiopathology , Blood-Brain Barrier , COVID-19 , Coronavirus Infections/complications , Humans , Hypothalamus/physiopathology , Medulla Oblongata/physiopathology , Nausea/etiology , Neural Pathways/physiopathology , Olfaction Disorders/etiology , Olfactory Nerve , Pandemics , Pneumonia, Viral/complications , Vagus Nerve , Vomiting/etiology