Possible brain manifestations and sequelae in patients infected with SARS-CoV-2: a narrative literature review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i15.22910

Keywords:

SARS-CoV-2; COVID-19; Neurological symptoms.

Abstract

Introduction: SARS-CoV and SARS-CoV-2 belong to the genus betacoronavirus, of the family Coronaviridae, of the order Nidovirales. Such viruses are enveloped by a positive-sense single-stranded RNA genome and infect humans by affecting the lower respiratory tract. In the current pandemic scenario, it has been reported that, in addition to common flu manifestations, SARS-CoV-2 (the etiological agent of COVID-19) can cause complications in various organic systems, such as the cardiovascular and supposedly nervous. Objective: Prove or contradict the hypotheses related to neurological complications triggered by Sars-CoV-2. Search methodology: This is a descriptive literature review research in the following databases: PubMed, Scielo, CDSR, Google Scholar, BVS and EBSCO, with the descriptors "SARS-CoV-2", "neurological symptoms", "COVID-19", "spike protein", "neuroinvasion", "ACE2". Discussion: Coronaviruses can cause severe pulmonary manifestations that require intensive care unit treatment and, thus, infected patients may also suffer from indirect neurological complications of critical illnesses. Thus, the involvement of the central and peripheral nervous system may be related to hypoxia and endothelial damage, uncontrollable immune reaction and inflammation, in addition to other effects, mainly circulatory. Finally, the hypothesis about the neuroinvasive and neurovirulence properties of SARS-CoV-2 is based on the following evidence: biological plausibility of the involvement of the central nervous system (CNS) by other respiratory viruses and the illustration of cases of patients with COVID-19 that presented neurological manifestations. Final considerations: In this study, it was possible to see that patients affected by COVID-19 often have neurological involvement, especially elderly people with multiple risk factors.

References

Abootalebi, s., et al. (2020). Call to action: SARS-CoV-2 and CerebrovAscular DisordErs (CASCADE). Journal of Stroke and Cerebrovascular Diseases, 29 (9), 1-11.

Baig, A, M., et al. (2020). Evidência do vírus COVID-19 direcionado ao SNC: distribuição nos tecidos, interação vírus-hospedeiro e mecanismos neurotrópicos propostos. ACS Chem Neurosci., 11 (4), 995-998.

Bakera, D., et al. (2020). A biologia subjacente relacionada aos tratamentos de modificação da doença de esclerose múltipla durante a pandemia de COVID-19. Neurology, 5 (9), 45-56.

Bali, H. Y., et al. (2020). Atualização sobre as manifestações neurológicas de COVID-19. Life Sciences, 257 (15), 1-12.

Conde, C., et al. (2020). Neurotropism of SARS-CoV 2: mecanismos e manifestações. J. Neurol. Sci., 42 (11), 1-14.

Filatov, A., et al. (2020). Complicações neurológicas da doença coronavírus (COVID-19): encefalopatia. Cureus, 5 (1), 1-12.

Goldsmith, C. S., et al. (2020). Microscopia eletrônica de SARS-CoV-2: uma tarefa desafiadora. The Lancet, 5 (7), 1-9.

Hasöksüz, M., et al. (2020). Coronaviruses and SARS-CoV-2. Turkish Journal of Medical Sciences, 12 (4), 23-43.

Helms, J., et al. (2020). Características neurológicas na infecção grave por SARS-CoV-2. The New England Journal of Medicine, 4 (3), 1-13.

Hoffmann, M. et al. (2020). A entrada da célula SARS-CoV-2 depende de ACE2 e TMPRSS2 e é bloqueada por um inibidor de protease clinicamente comprovado. Cell., 181 (4), 271-280.

Instituto do Coração (INCOR). (2021). Estudo inédito no mundo realizado no InCor mostra que pacientes que tiveram Covid-19 podem sofrer disfunções cognitivas. São Paulo, 1 de fevereiro de 2021. Disponível em: http://www.incor.usp.br/sites/incor2013/docs/2021_Fevereiro_Estudo_Mental_Plus.pdf

Iser, B. P. M., et al. (2020). Definição de caso suspeito da COVID-19: uma revisão narrativa dos sinais e sintomas mais frequentes entre os casos confirmados. Epidemiol. Serv. Saúde, 29 (3), 1-10.

Jensen, M. P., et al. (2020). Achados neuropatológicos em dois pacientes com COVID ‐ 19 fatal. Neuropathol. Appl. Neurobiol., 21 (6), 45-56.

Klein, B. C., et al. (2020). COVID-19 está catalisando a adoção da teleneurologia. Neurology, 43 (5), 76-81.

Leonardi, M., et al. (2020). Neurological manifestations associated with COVID 19: a review and a call for action. Journal of Neurology, 267 (9), 1573-1576.

Li, T. C., et al. O potencial neuroinvasivo do SARS-CoV-2 pode desempenhar um papel na insuficiência respiratória de pacientes com COVID-19. J Med Virol., 3 (6).

Malik, Y. A. (2020). Properties of Coronavirus and SARS-CoV-2. Malasyan Journal Pathology, 42 (1), 3-11.

Mao, L., et al. (2020). Manifestações neurológicas de pacientes hospitalizados com doença coronavírus 2019 em Wuhan, China. JAMA Neurol., 5 (9), 1-13.

Mehra, M. R., et al. (2020). Cardiovascular Disease, Drug Therapy, and Mortality in Covid-19. The New England Journal of Medicine, 4 (7), 1-21.

Meinhardt, J., et al. (2021). Invasão transmucosa olfatória de SARS-CoV-2 como porta de entrada do sistema nervoso central em indivíduos com COVID-19. Nature Neuroscience, 24 (4), 168–175.

Naughton, S. X., et al. (2020). Novo papel potencial de COVID-19 na doença de Alzheimer e estratégias de mitigação preventiva. J Alzheimers Dis., 4 (1), 23-42.

Niazkar, H. R., et al. (2020). The neurological manifestations of COVID-19: a review article. Neurological Sciences, 41 (3), 1667-1671.

Oxley, T. J., et al. (2020). O AVC de grandes vasos como uma característica de apresentação do Covid-19 nos jovens. N. Engl. J. Med., 382 (60), 1-9.

Reichard, R. R., et al. (2020). Neuropatologia de COVID-19: Um espectro de patologia semelhante à encefalomielite disseminada aguda e vascular (ADEM). Acta Neuropayhology, 140 (1), 1-6.

Solomon, I. H., et al. (2020). Características neuropatológicas de Covid-19. N. Engl. J. Med., 383 (7), 989–992.

Steardo, L., et al. (2020). A neuroinfecção pode contribuir para a fisiopatologia e manifestações clínicas da COVID ‐ 19. Acta Physiology, 229 (3), 34-40.

Tsivgoulis, G., et al. (2020). Manifestações neurológicas e implicações da pandemia de COVID-19. Avanços terapêuticos em doenças neurológicas, 10 (4), 1-11.

Varga, Z., et al. (2020). Infecção de células endoteliais e endotelite em COVID-19. The Lancet, 395 (10), 1417-1418.

Waldman, G., et al. (2020). Preparando um departamento de neurologia para SARS-CoV-2 (COVID-19): Primeiras experiências na Columbia University Irving Medical Center e no New York Presbyterian Hospital na cidade de Nova. Neurology, 5 (43).

Wang, H. Y., et al. (2020). Sintomas neurológicos potenciais de COVID-19. Ther Adv Neurol Disord., 14 (8), 1-7.

Xiang, P., et al. (2020). Primeiro caso de nova doença por coronavírus em 2019 com encefalite. ChinaXiv, 5 (1), 1-12.

Zubair, A. S., et al. (2020). Neuropathogenesis and neurologic manifestations of the coronaviruses in the age of coronavirus disease 2019: a review. JAMA, 77 (8), 1018-1027.

Published

24/11/2021

How to Cite

FIGUEIREDO, B. Q. de .; AFONSO, A. R.; DUTRA, D. S.; CARDOSO, I. B.; NAGATA, L. M.; BRAGA, V. E. G.; ALMEIDA, M. G. de . Possible brain manifestations and sequelae in patients infected with SARS-CoV-2: a narrative literature review. Research, Society and Development, [S. l.], v. 10, n. 15, p. e207101522910, 2021. DOI: 10.33448/rsd-v10i15.22910. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/22910. Acesso em: 25 apr. 2024.

Issue

Section

Health Sciences