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SARS-CoV-2: is there neuroinvasion?
Conor McQuaid1, Molly Brady1, Rashid Deane2
1Department of Neuroscience, University of Rochester, URMC, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
Fluids and Barriers of the CNS
|July 15, 2021
Summary
The coronavirus (SARS-CoV-2) can cause neurological issues, but evidence for significant brain invasion is lacking. Further research is needed to understand how the virus affects the brain and its potential neuroinvasion pathways.
Area of Science:
- Neurology
- Virology
- Infectious Diseases
Background:
- SARS-CoV-2 (coronavirus) causes respiratory illness and non-respiratory complications, especially in older males with pre-existing conditions like obesity, diabetes, and hypertension.
- These conditions are linked to vascular dysfunction, and COVID-19 complications can include multiorgan failure and neurological problems.
- While primarily inhaled, SARS-CoV-2 has been detected in various tissues, including brain structures and cerebrospinal fluid (CSF).
Purpose of the Study:
- To review the literature on SARS-CoV-2, its receptor (ACE2) distribution, and its effects on the central nervous system (CNS).
- To explore potential mechanisms of viral entry into the brain and the role of pre-existing health conditions.
- To elucidate the significance of neurological complications in COVID-19 and the factors influencing brain vulnerability.
Main Methods:
- Literature review of SARS-CoV-2/COVID-19, ACE2 distribution, CNS vascular barriers, and viral entry mechanisms.
- Analysis of pre-existing health conditions (obesity, hypertension, diabetes) and their impact on neurological manifestations.
- Examination of the aging cerebrovasculature and its potential role in COVID-19 neurological outcomes.
Main Results:
- While SARS-CoV-2 is found in the brains of severely ill patients, the extent of its flux into the brain is not well-established.
- Current evidence does not strongly support significant SARS-CoV-2 invasion of the brain contributing to overall COVID-19 outcomes.
- The olfactory mucosa is considered a potential route for the virus to enter the brain.
Conclusions:
- The precise pathway and extent of SARS-CoV-2 neuroinvasion remain unclear.
- Further studies are required to confirm viral entry, replication within the brain parenchyma, and its contribution to neurological symptoms.
- Neurological manifestations may primarily result from systemic effects like cardio-respiratory distress and multiorgan failure, rather than direct viral neuroinvasion.
