Potential Neurocognitive Symptoms Due to Respiratory Syncytial Virus Infection.

Catalina A Andrade,Karen Bohmwald,Alexis M Kalergis

doi:10.3390/pathogens11010047

Abstract

Respiratory infections are among the major public health burdens, especially during winter. Along these lines, the human respiratory syncytial virus (hRSV) is the principal viral agent causing acute lower respiratory tract infections leading to hospitalization. The pulmonary manifestations due to hRSV infection are bronchiolitis and pneumonia, where the population most affected are infants and the elderly. However, recent evidence suggests that hRSV infection can impact the mother and fetus during pregnancy. Studies have indicated that hRSV can infect different cell types from the placenta and even cross the placenta barrier and infect the fetus. In addition, it is known that infections during the gestational period can lead to severe consequences for the development of the fetus due not only to a direct viral infection but also because of maternal immune activation (MIA). Furthermore, it has been described that the development of the central nervous system (CNS) of the fetus can be affected by the inflammatory environment of the uterus caused by viral infections. Increasing evidence supports the notion that hRSV could invade the CNS and infect nervous cells, such as microglia, neurons, and astrocytes, promoting neuroinflammation. Moreover, it has been described that the hRSV infection can provoke neurological manifestations, including cognitive impairment and behavioral alterations. Here, we will review the potential effect of hRSV in brain development and the potential long-term neurological sequelae.

Highlights

Respiratory infections are a major public health burden due to the high hospitalizations, morbidity, and mortality rates [1,2]
The respiratory pathologies associated with human respiratory syncytial virus (hRSV) infection can vary from rhinorrhea, cough, congestion, low-grade fever, and respiratory distress, leading to more severe symptoms such as bronchiolitis and pneumonia [1,3,5]
All these results show the impact of the hRSV infection on pregnant women and the ability of the virus to cross the placenta, infect the fetus, and induce susceptibility to develop long-lasting lung pathology, including asthma

Summary

Introduction

Respiratory infections are a major public health burden due to the high hospitalizations, morbidity, and mortality rates [1,2]. Even though the transplacental transmission of the Influenza virus is controversial and it depends on several factors, including the used strain, the fact is that prenatal infection affects the brain development of the fetus [30,70,72–74] This viral agent is one of the respiratory viruses most characterized regarding its effects on the CNS, and it is known to cause neurological symptoms, such as encephalitis, febrile seizures, and delirium [19], so being related to the detrimental development of the brain is not strange. In this context, the viral infection on gestational day 12 (GD12) with the strain Hk-x31 (H3N2) mouse-adapted promotes an exacerbated systemic immune response and disfunction of the major arteries and in the fetus induces a hypoxic state and angiogenesis in the brain [30]. There is no detailed information on how hRSV affects brain development and needs to be evaluated in the future

Neurological Consequences due to hRSV Infection

Findings

Conclusions