Abstract
BackgroundAlthough coronavirus disease 2019 (COVID‐19) has been associated primarily with pneumonia, recent data show that the causative agent of COVID‐19, the coronavirus severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), can infect a large number of vital organs beyond the lungs, such as the heart, kidneys, and the brain. Thus, there is evidence showing possible retrograde transmission of the virus from the olfactory epithelium to regions of the brain stem.MethodsThis is a literature review article. The research design method is an evidence‐based rapid review. The present discourse aim is first to scrutinize and assess the available literature on COVID‐19 repercussion on the central nervous system (CNS). Standard literature and database searches were implemented, gathered relevant material, and extracted information was then assessed.ResultsThe angiotensin‐converting enzyme 2 (ACE2) receptors being the receptor for the virus, the threat to the central nervous system is expected. Neurons and glial cells express ACE2 receptors in the CNS, and recent studies suggest that activated glial cells contribute to neuroinflammation and the devastating effects of SARS‐CoV‐2 infection on the CNS. The SARS‐CoV‐2‐induced immune‐mediated demyelinating disease, cerebrovascular damage, neurodegeneration, and depression are some of the neurological complications discussed here.ConclusionThis review correlates present clinical manifestations of COVID‐19 patients with possible neurological consequences in the future, thus preparing healthcare providers for possible future consequences of COVID‐19.
Highlights
Coronavirus disease‐19 (COVID‐19) was first identified in Wuhan, China, in early December 2019
Infection of the human astrocytic cell lines U‐373MG with the OC43 strain of human coronavirus led to increased transcription of IL‐6, TNF‐α, and MCP‐1, altered matrix metalloproteinases‐2 and 9 activity, and upregulation of nitric oxide production in both U‐373 cells and CHME‐5 human microglial cell lines.[33]. These results suggest a possible role of coronavirus‐induced glial cell mediated inflammation leading to conditions such as immune mediated demyelination of neurons
Another study found higher D‐dimer or fibrin degradation product levels predisposing to a hypercoagulable state, and lower platelet count‐induced cerebrovascular hemorrhage in severe acute respiratory syndrome (SARS)‐CoV‐2 positive cases.[50,51,52]
Summary
Coronavirus disease‐19 (COVID‐19) was first identified in Wuhan, China, in early December 2019.
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