ABSTRACT
INTRODUCTION: SARS-CoV-2 was first detected in December 2019 in the Chinese city of Wuhan and has since spread across the world. At present, the virus has infected over 1.7 million people and caused over 100 000 deaths worldwide. Research is currently focused on understanding the acute infection and developing effective treatment strategies. In view of the magnitude of the epidemic, we conducted a speculative review of possible medium- and long-term neurological consequences of SARS-CoV-2 infection, with particular emphasis on neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin, based on the available evidence on neurological symptoms of acute SARS-CoV-2 infection. DEVELOPMENT: We systematically reviewed the available evidence about the pathogenic mechanisms of SARS-CoV-2 infection, the immediate and lasting effects of the cytokine storm on the central nervous system, and the consequences of neuroinflammation for the central nervous system. CONCLUSIONS: SARS-CoV-2 is a neuroinvasive virus capable of triggering a cytokine storm, with persistent effects in specific populations. Although our hypothesis is highly speculative, the impact of SARS-CoV-2 infection on the onset and progression of neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin should be regarded as the potential cause of a delayed pandemic that may have a major public health impact in the medium to long term. Cognitive and neuropsychological function should be closely monitored in COVID-19 survivors.
Subject(s)
Betacoronavirus/pathogenicity , Coronavirus Infections/complications , Cytokine Release Syndrome/etiology , Cytokines/physiology , Mental Disorders/etiology , Neurodegenerative Diseases/etiology , Pandemics , Pneumonia, Viral/complications , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/physiopathology , Cytokine Release Syndrome/physiopathology , Cytokine Release Syndrome/psychology , Disease Progression , Humans , Immune System/physiopathology , Immune System/virology , Inflammation , Inflammation Mediators/physiology , Mental Disorders/epidemiology , Models, Immunological , Models, Neurological , Neurodegenerative Diseases/epidemiology , Neuroimmunomodulation/physiology , Pneumonia, Viral/epidemiology , Pneumonia, Viral/physiopathology , Public Health , SARS-CoV-2 , Time FactorsSubject(s)
Chromosomes, Human, Pair 20 , Epilepsy/genetics , Mosaicism , Ring Chromosomes , Age of Onset , HumansABSTRACT
INTRODUCTION: The ring-shaped chromosome 20 (r20) syndrome is an infrequent chromosopathy which is associated with epileptic seizures, behaviour disorders and mental retardation. It results from the fusion of the two arms of the chromosome with deletion of the telomeric portions. CLINICAL CASE: We present a case of r20, review published cases and describe the clinical and neurophysiological characteristics. CONCLUSIONS: The r20 syndrome is the third type of epilepsy known to be of genetic basis related to chromosome 20. It has clinical and neurophysiological characteristics which give it a distinctive character and are easily identified. The fact that on locus 20q13 (telomeric portion of the long arm of chromosome 20) two genes related to epileptic channelopathies (CHRNA4 and KCNQ2) have been described, suggest the hypothesis that the subjacent deletion in cases of r20 syndrome affect one of these genes and explains the epileptogenicity. We consider this hypothesis and the possibility that r20 syndrome may be an epileptic channelopathy.
