Neuroimmunoendocrinology of SARS-CoV 2 Infection

Area of Science:

• Neuroendocrinology
• Infectious Diseases
• Immunology

Background:

• SARS-CoV-2 targets cells expressing Angiotensin-Converting Enzyme 2 (ACE2).
• The central nervous system (CNS), including hypothalamic-pituitary structures, expresses ACE2, making it vulnerable to SARS-CoV-2.
• COVID-19 infection can lead to acute and post-infection central endocrine disorders.

Purpose of the Study:

• To review and discuss the neuroimmune endocrinological aspects of SARS-CoV-2 infection.
• To identify characteristic findings and ongoing controversies regarding COVID-19's endocrine effects.
• To highlight the impact of SARS-CoV-2 on the hypothalamic-pituitary axis and associated glands.

Main Methods:

• Literature review using PubMed and Scopus databases.
• Inclusion of original studies, observational studies, reviews, meta-analyses, and case reports.
• Analysis focused on neuroimmune endocrinological findings related to SARS-CoV-2.

Main Results:

• SARS-CoV-2 infection affects the CNS, particularly the hypothalamic-pituitary axis, due to ACE2 expression.
• The virus may trigger autoimmune processes targeting the hypothalamus-pituitary region.
• Reported dysfunctions include adrenal, thyroid, gonadal issues, and alterations in growth hormone (GH) and prolactin secretion.

Conclusions:

• SARS-CoV-2 infection can cause central endocrine disorders via CNS involvement, particularly affecting the hypothalamic-pituitary axis.
• Autoimmune responses to the virus may contribute to endocrine dysfunction.
• The full extent of short- and long-term endocrine effects of COVID-19 requires further investigation.