Encephalitic syndrome and anosmia in COVID-19: Do these clinical presentations really reflect SARS-CoV-2 neurotropism? A theory based on the review of 25 COVID-19 cases.

Journal of Medical Virology
Lydia Pouga

Abstract

Since the discovery of coronavirus disease 2019 (COVID-19), a disease caused by the new coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathology showed different faces. There is an increasing number of cases described as (meningo)encephalitis although evidence often lacks. Anosmia, another atypical form of COVID-19, has been considered as testimony of the potential of neuroinvasiveness of SARS-CoV-2, though this hypothesis remains highly speculative. We did a review of the cases reported as brain injury caused by SARS-CoV-2. Over 98 papers found, 21 were analyzed. Only four publications provided evidence of the presence of SARS-CoV-2 within the central nervous system (CNS). When facing acute neurological abnormalities during an infectious episode it is often difficult to disentangle neurological symptoms induced by the brain infection and those due to the impact of host immune response on the CNS. Cytokines release can disturb neural cells functioning and can have in the most severe cases vascular and cytotoxic effects. An inappropriate immune response can lead to the production of auto-antibodies directed toward CNS components. In the case of proven SARS-CoV-2 brain invasion, the main hypothesis ...Continue Reading

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Citations

Mar 2, 2021·Frontiers in Neurology·Dean W A WaltonBenedict Daniel Michael
May 7, 2021·Clinical Medicine Insights. Case Reports·Fahmin BasherDenise L Pereira
May 14, 2021·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Isabel SiowAdeline Ng
Jul 31, 2021·Frontiers in Immunology·Alice H GrantRobert A Kirken

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