How can a respiratory pathogen like SARS-CoV-2 cause the nervous system to go haywire?
That’s a question yet to be answered, observed Serena Spudich, MD, MA, of Yale University, and Avindra Nath, MD, of the National Institute of Neurological Disorders and Stroke, in an essay in Science.
“Though COVID-19 is well known as a respiratory disease, neurological symptoms such as confusion, strokes, headaches, weakness, and nerve problems also occur in some patients around the time of the initial illness,” Spudich told MedPage Today.
“Additionally, some people have difficulties with thinking, abnormal skin sensations, headaches, and other neurological symptoms for months after recovery from COVID-19,” she continued.
“Despite early speculation that SARS-CoV-2 may enter the CNS via migration through the nasal cavity and the olfactory pathway or trafficking across the blood-brain barrier, analysis of cerebrospinal fluid (CSF) from living patients with neuropsychiatric manifestations has almost uniformly failed to detect viral RNA by reverse transcription polymerase chain reaction,” Spudich and Nath noted.
Instead, most evidence from CSF and brain tissue suggests that immune activation and inflammation within the CNS is the primary driver of neurologic disease in acute COVID-19, they said.
