How Does SARS-CoV-2 Affect the Central Nervous System? A Working Hypothesis
Interstitial pneumonia was the first manifestation to be recognized as caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, in just a few weeks, it became clear that the coronavirus disease-2019 (COVID-19) overrun tissues and more body organs than just the lungs, so much...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-11-01
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| Series: | Frontiers in Psychiatry |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2020.582345/full |
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| author | Fabio Panariello Lorenzo Cellini Maurizio Speciani Diana De Ronchi Anna Rita Atti |
| author_facet | Fabio Panariello Lorenzo Cellini Maurizio Speciani Diana De Ronchi Anna Rita Atti |
| author_sort | Fabio Panariello |
| collection | DOAJ |
| description | Interstitial pneumonia was the first manifestation to be recognized as caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, in just a few weeks, it became clear that the coronavirus disease-2019 (COVID-19) overrun tissues and more body organs than just the lungs, so much so that it could be considered a systemic pathology. Several studies reported the involvement of the conjunctiva, the gut, the heart and its pace, and vascular injuries such as thromboembolic complications and Kawasaki disease in children and toddlers were also described. More recently, it was reported that in a sample of 214 SARS-CoV-2 positive patients, 36.4% complained of neurological symptoms ranging from non-specific manifestations (dizziness, headache, and seizures), to more specific symptoms such hyposmia or hypogeusia, and stroke. Older individuals, especially males with comorbidities, appear to be at the highest risk of developing such severe complications related to the Central Nervous System (CNS) involvement. Neuropsychiatric manifestations in COVID-19 appear to develop in patients with and without pre-existing neurological disorders. Growing evidence suggests that SARS-CoV-2 binds to the human Angiotensin-Converting Enzyme 2 (ACE2) for the attachment and entrance inside host cells. By describing ACE2 and the whole Renin Angiotensin Aldosterone System (RAAS) we may better understand whether specific cell types may be affected by SARS-CoV-2 and whether their functioning can be disrupted in case of an infection. Since clear evidences of neurological interest have already been shown, by clarifying the topographical distribution and density of ACE2, we will be able to speculate how SARS-CoV-2 may affect the CNS and what is the pathogenetic mechanism by which it contributes to the specific clinical manifestations of the disease. Based on such evidences, we finally hypothesize the process of SARS-CoV-2 invasion of the CNS and provide a possible explanation for the onset or the exacerbation of some common neuropsychiatric disorders in the elderly including cognitive impairment and Alzheimer disease. |
| first_indexed | 2024-12-14T08:19:50Z |
| format | Article |
| id | doaj.art-c2851da7222f45dcab5dbf71da239ed6 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-12-14T08:19:50Z |
| publishDate | 2020-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-c2851da7222f45dcab5dbf71da239ed62022-12-21T23:09:49ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402020-11-011110.3389/fpsyt.2020.582345582345How Does SARS-CoV-2 Affect the Central Nervous System? A Working HypothesisFabio Panariello0Lorenzo Cellini1Maurizio Speciani2Diana De Ronchi3Anna Rita Atti4Department of Mental Health, Local Health Authorities, Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, Psychiatry, Bologna University, Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, Psychiatry, Bologna University, Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, Psychiatry, Bologna University, Bologna, ItalyDepartment of Biomedical and Neuromotor Sciences, Psychiatry, Bologna University, Bologna, ItalyInterstitial pneumonia was the first manifestation to be recognized as caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, in just a few weeks, it became clear that the coronavirus disease-2019 (COVID-19) overrun tissues and more body organs than just the lungs, so much so that it could be considered a systemic pathology. Several studies reported the involvement of the conjunctiva, the gut, the heart and its pace, and vascular injuries such as thromboembolic complications and Kawasaki disease in children and toddlers were also described. More recently, it was reported that in a sample of 214 SARS-CoV-2 positive patients, 36.4% complained of neurological symptoms ranging from non-specific manifestations (dizziness, headache, and seizures), to more specific symptoms such hyposmia or hypogeusia, and stroke. Older individuals, especially males with comorbidities, appear to be at the highest risk of developing such severe complications related to the Central Nervous System (CNS) involvement. Neuropsychiatric manifestations in COVID-19 appear to develop in patients with and without pre-existing neurological disorders. Growing evidence suggests that SARS-CoV-2 binds to the human Angiotensin-Converting Enzyme 2 (ACE2) for the attachment and entrance inside host cells. By describing ACE2 and the whole Renin Angiotensin Aldosterone System (RAAS) we may better understand whether specific cell types may be affected by SARS-CoV-2 and whether their functioning can be disrupted in case of an infection. Since clear evidences of neurological interest have already been shown, by clarifying the topographical distribution and density of ACE2, we will be able to speculate how SARS-CoV-2 may affect the CNS and what is the pathogenetic mechanism by which it contributes to the specific clinical manifestations of the disease. Based on such evidences, we finally hypothesize the process of SARS-CoV-2 invasion of the CNS and provide a possible explanation for the onset or the exacerbation of some common neuropsychiatric disorders in the elderly including cognitive impairment and Alzheimer disease.https://www.frontiersin.org/articles/10.3389/fpsyt.2020.582345/fullCOVID-19SARS-CoVRAASACE2Ang(1-7)/Masbrain aging |
| spellingShingle | Fabio Panariello Lorenzo Cellini Maurizio Speciani Diana De Ronchi Anna Rita Atti How Does SARS-CoV-2 Affect the Central Nervous System? A Working Hypothesis Frontiers in Psychiatry COVID-19 SARS-CoV RAAS ACE2 Ang(1-7)/Mas brain aging |
| title | How Does SARS-CoV-2 Affect the Central Nervous System? A Working Hypothesis |
| title_full | How Does SARS-CoV-2 Affect the Central Nervous System? A Working Hypothesis |
| title_fullStr | How Does SARS-CoV-2 Affect the Central Nervous System? A Working Hypothesis |
| title_full_unstemmed | How Does SARS-CoV-2 Affect the Central Nervous System? A Working Hypothesis |
| title_short | How Does SARS-CoV-2 Affect the Central Nervous System? A Working Hypothesis |
| title_sort | how does sars cov 2 affect the central nervous system a working hypothesis |
| topic | COVID-19 SARS-CoV RAAS ACE2 Ang(1-7)/Mas brain aging |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2020.582345/full |
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