Placantonakis Dimitris G, Aguero-Rosenfeld Maria, Flaifel Abdallah, Colavito John, Inglima Kenneth, Zagzag David, Snuderl Matija, Louie Eddie, Frontera Jennifer Ann, Lewis Ariane
NYU Grossman School of Medicine and NYU Langone Health, New York, NY, United States.
Front Neurol. 2020 Dec 11;11:587384. doi: 10.3389/fneur.2020.587384. eCollection 2020.
Neurologic manifestations of the novel coronavirus SARS-CoV-2 infection have received wide attention, but the mechanisms remain uncertain. Here, we describe computational data from public domain RNA-seq datasets and cerebrospinal fluid data from adult patients with severe COVID-19 pneumonia that suggest that SARS-CoV-2 infection of the central nervous system is unlikely. We found that the mRNAs encoding the ACE2 receptor and the TMPRSS2 transmembrane serine protease, both of which are required for viral entry into host cells, are minimally expressed in the major cell types of the brain. In addition, CSF samples from 13 adult encephalopathic COVID-19 patients diagnosed with the viral infection via nasopharyngeal swab RT-PCR did not show evidence for the virus. This particular finding is robust for two reasons. First, the RT-PCR diagnostic was validated for CSF studies using stringent criteria; and second, 61% of these patients had CSF testing within 1 week of a positive nasopharyngeal diagnostic test. We propose that neurologic sequelae of COVID-19 are not due to SARS-CoV-2 meningoencephalitis and that other etiologies are more likely mechanisms.
新型冠状病毒SARS-CoV-2感染的神经学表现已受到广泛关注，但其机制仍不确定。在此，我们描述了来自公共领域RNA测序数据集的计算数据以及来自重症COVID-19肺炎成年患者的脑脊液数据，这些数据表明SARS-CoV-2感染中枢神经系统的可能性不大。我们发现，编码血管紧张素转换酶2（ACE2）受体和跨膜丝氨酸蛋白酶2（TMPRSS2）的信使核糖核酸（mRNA），这两者都是病毒进入宿主细胞所必需的，在大脑的主要细胞类型中表达极少。此外，通过鼻咽拭子逆转录聚合酶链反应（RT-PCR）确诊为病毒感染的13例成年COVID-19脑病患者的脑脊液样本未显示病毒迹象。这一特殊发现很可靠，原因有两个。第一，RT-PCR诊断在脑脊液研究中使用严格标准进行了验证；第二，这些患者中有61%在鼻咽诊断检测呈阳性后的1周内进行了脑脊液检测。我们提出，COVID-19的神经后遗症并非由SARS-CoV-2脑膜脑炎引起，其他病因更可能是其机制。
