Abstract
Coronavirus 2019 (COVID-19) is an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that mainly affects the lungs. COVID-19 symptoms include the presence of fevers, dry coughs, fatigue, sore throat, headaches, diarrhea, and a loss of taste or smell. However, it is understood that SARS-CoV-2 is neurotoxic and neuro-invasive and could enter the central nervous system (CNS) via the hematogenous route or via the peripheral nerve route and causes encephalitis, encephalopathy, and acute disseminated encephalomyelitis (ADEM) in COVID-19 patients. This review discusses the possibility of SARS-CoV-2-mediated Multiple Sclerosis (MS) development in the future, comparable to the surge in Parkinson’s disease cases following the Spanish Flu in 1918. Moreover, the SARS-CoV-2 infection is associated with a cytokine storm. This review highlights the impact of these modulated cytokines on glial cell interactions within the CNS and their role in potentially prompting MS development as a secondary disease by SARS-CoV-2. SARS-CoV-2 is neurotropic and could interfere with various functions of neurons leading to MS development. The influence of neuroinflammation, microglia phagocytotic capabilities, as well as hypoxia-mediated mitochondrial dysfunction and neurodegeneration, are mechanisms that may ultimately trigger MS development.
Highlights
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected more than 174.9 million globally [1]
The world is in a race against the COVID-19 pandemic, with a significant focus on patient care and substantial research in developing and implementing strategies to eliminate the virus’s spread
Many studies have confirmed the existence of neurological issues as a long-term effect associated with post-COVID-19 infection
Summary
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has affected more than 174.9 million globally [1]. Viruses 2021, 13, x FOR PEER REVIEW cases that exhibit headaches, a loss of smell and taste, confusion, dizziness, and impaired consciousness highlight an essential and influential link between SARS-CoV-2 infection and the CNS [8,9,12,13]. This review emphasizes the possible neuro-invasive route of SARS-CoV-2 and its association with encephalitis, encephalopathy, acute disseminated encephalomyelitis (ADE2 Mof),16and the possibility of developing MS and other neurological diseases as a secondary effect due to SARS-CoV-2 infection. 2. Mechanisms of SARS-CoV-2 Invasion and the Effects on the Nervous System COVID-19 exhibits highly heterogenous respiratory symptoms ranging from hypoxia cases Tahsesomcioadteedofwzoitohnorteiscptirraantsofreyr offacilourroen—avaicruutsefrroemspbiaratstotoryhudmisatrnessisn sSyAnRdSr,oMmEeRS, and (ARDS)C—OtoVImDi-n1o9rissyvmiapatnoimntseromr eadsyiamtephtoomstastuicchcoans dciivtieotncsat[s3,]c.aSmigenlsif,iacnandtpcalningiocalilnssy, rmespp-ectively toms ca(uFsiegdurbey1)S[A1R4]S. Tnehuerfoo-lilnovwaisnivgesruobusteecotifoSnAs RwSi-llCeoxVp-lain the 2 and itpsoatessnoticaial tnioeunrwoliotghiceanlcceopmhaplliitcias,tieonncseipmhpalliocpaatetdhyi,naScAuRteSd-CisosVe-m2iinnafteecdtioenn.cephalomyelitis (ADEM), and the possibility of developing MS and other neurological diseases as a secondary effect due to SARS-CoV-2 infection
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