Sorbonne Université, INSERM U938, Biology and Cancer Therapeutics, Centre de Recherche Saint Antoine, Saint Antoine Hospital, 75231 Paris, France.
Sorbonne Université, CNRS UMR 7238, Laboratoire de Biologie Computationnelle et Quantitative, Institut de Biologie Paris-Seine, 75005 Paris, France.
Biomolecules. 2024 Aug 28;14(9):1081. doi: 10.3390/biom14091081.
Long-lasting COVID-19 (long COVID) diseases constitute a real life-changing burden for many patients around the globe and, overall, can be considered societal and economic issues. They include a variety of symptoms, such as fatigue, loss of smell (anosmia), and neurological-cognitive sequelae, such as memory loss, anxiety, brain fog, acute encephalitis, and stroke, collectively called long neuro-COVID-19 (long neuro-COVID). They also include cardiopulmonary sequelae, such as myocardial infarction, pulmonary damage, fibrosis, gastrointestinal dysregulation, renal failure, and vascular endothelial dysregulation, and the onset of new diabetes, with each symptom usually being treated individually. The main unmet challenge is to understand the mechanisms of the pathophysiologic sequelae, in particular the neurological symptoms. This mini-review presents the main mechanistic hypotheses considered to explain the multiple long neuro-COVID symptoms, namely immune dysregulation and prolonged inflammation, persistent viral reservoirs, vascular and endothelial dysfunction, and the disruption of the neurotransmitter signaling along various paths. We suggest that the nucleoprotein N of SARS-CoV-2 constitutes a "hub" between the virus and the host inflammation, immunity, and neurotransmission.
长期 COVID-19(长新冠)疾病给全球许多患者带来了真正改变生活的负担,总体而言,可被视为社会和经济问题。它们包括各种症状,如疲劳、嗅觉丧失(嗅觉障碍)和神经认知后遗症,如记忆力减退、焦虑、脑雾、急性脑炎和中风,统称为长新冠神经后遗症(long neuro-COVID)。它们还包括心肺后遗症,如心肌梗死、肺部损伤、纤维化、胃肠道失调、肾衰竭和血管内皮失调,以及新发糖尿病的发作,每种症状通常都需要单独治疗。主要的未满足的挑战是了解病理生理后遗症的机制,特别是神经症状。这篇迷你综述提出了被认为可以解释多种长新冠神经症状的主要机制假说,即免疫失调和持续炎症、持续存在的病毒储库、血管和内皮功能障碍以及沿着各种途径破坏神经递质信号传递。我们认为,SARS-CoV-2 的核蛋白 N 构成了病毒与其宿主炎症、免疫和神经传递之间的“枢纽”。
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