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- Human coronaviruses generally cause GI and respiratory diseases.
- However, myocarditis, meningitis, and multi-organ failure have also been reported.
- Like other viruses, human coronaviruses may enter the central nervous system (CNS) hematogenously or through neuronal retrograde.
- The novel coronavirus (SARS-CoV-2) that emerged in Wuhan, China in December 2019 shares similar pathogenesis with SARS-CoV and MERS-CoV, and has been identified to use the same ACE2 receptor as SARS-CoV.
- Experimentally, SARS-CoV has been shown to cause neuronal death by invading the brain close to the olfactory epithelium.
- Patients with SARS have also been found to have the virus in their cerebrospinal fluid (CSF).
- An altered sense of smell, or hyposmia, has been observed in COVID-19 and may warrant an evaluation for potential CNS involvement.
Bottom Line: SARS-CoV has been associated with CNS involvement. Given their similar pathogenesis and finding of hyposmia in COVID-19, SARS-CoV-2 may be associated with risk of CNS involvement.
References
- Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 virus targeting the CNS: Tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci. 2020 Mar 13 [Online ahead of print]
- Li Y-C, Bai W-Z, Hashikawa T. The neuroinvasiveness potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020 Feb 27 [Epub ahead of print]
- Desforges M, Le Coupanec A, Dubeau P, et al. Human coronaviruses and other respiratory viruses: Underestimated opportunistic pathogens of the central nervous system? Viruses. 2019;12(1):14.
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