Laboratory Teaching Center of Basic Medicine, Norman Bethune Health Science Center of Jilin University, Jilin, China.
Department of Histology and Embryology, College of Basic Medical Sciences, Norman Bethune College of Medicine, Jilin University, Changchun, Jilin, China.
Aging (Albany NY). 2021 Feb 14;13(3):4713-4730. doi: 10.18632/aging.202665.
The peculiar features of coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), are challenging the current biological knowledge. Early in Feb, 2020, we suggested that SARS-CoV-2 may possess neuroinvasive potential similar to that of many other coronaviruses. Since then, a variety of neurological manifestations have been associated with SARS-CoV-2 infection, which was supported in some patients with neuroimaging and/or cerebrospinal fluid tests. To date, at least 27 autopsy studies on the brains of COVID-19 patients can be retrieved through PubMed/MEDLINE, among which neuropathological alterations were observed in the brainstem in 78 of 134 examined patients, and SARS-CoV-2 nucleic acid and viral proteins were detected in the brainstem in 16/49 (32.7%) and 18/71 (25.3%) cases, respectively. To shed some light on the peculiar respiratory manifestations of COVID-19 patients, this review assessed the existing evidence about the neurogenic mechanism underlying the respiratory failure induced by SARS-CoV-2 infection. Acknowledging the neurological involvement has important guiding significance for the prevention, treatment, and prognosis of SARS-CoV-2 infection.
2019 年冠状病毒病(COVID-19)是由严重急性呼吸系统综合征冠状病毒 2(SARS-CoV-2)引起的,其具有一些特殊特征,这对目前的生物学知识提出了挑战。早在 2020 年 2 月,我们就提出 SARS-CoV-2 可能具有类似于许多其他冠状病毒的神经侵袭潜力。从那时起,越来越多的研究表明,SARS-CoV-2 感染与多种神经系统表现相关,这在一些伴有神经影像学和/或脑脊液检查的患者中得到了证实。迄今为止,通过 PubMed/MEDLINE 至少可以检索到 27 项关于 COVID-19 患者大脑的尸检研究,其中 134 例患者中有 78 例在脑干中观察到神经病理学改变,在 49 例中有 16 例(32.7%)和 71 例中有 18 例(25.3%)分别在脑干中检测到 SARS-CoV-2 核酸和病毒蛋白。为了阐明 COVID-19 患者呼吸窘迫的特殊表现,本综述评估了目前关于 SARS-CoV-2 感染引起呼吸衰竭的神经发生机制的证据。承认神经系统受累对 SARS-CoV-2 感染的预防、治疗和预后具有重要的指导意义。
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