Patients who have recovered from SARS-Cov-1 demonstrate higher risks of developing Parkinson’s disease and multiple sclerosis. 31-50 months after the acute SARS-Cov-1 infection, Troyer et. al found evidence for post-traumatic stress disorder (39%), depression (36.4%), obsessive convulsive disorder (15.6%), and panic disorders (15.6%).


Syracuse University

Many of the known coronaviruses are neurotropic, meaning they are able to infect neuron cells.  If these observed trends carry over to SARS-CoV-2, they could help to elucidate how the CNS is affected by COVID-19.  Some of the key observations include:

- human coronavirus OC43 was shown to transmit itself to different neurons via axons in mice
- neuronal ACE2 expression in mice was found to be in different pre-autonomic regions of the brain which could explain why infected COVID-19 patients with dangerously low blood oxygen levels don't gasp for air
- SARS-CoV was found to infect regions of the brain that deal with cardiopulmonary regulation in human ACE2 knock-in mice
- SARS-CoV patient autopsies showed that the virus affected neurons more than any other kind of cell

Trends in Other Coronaviruses Affecting the CNS
 Relevant to COVID-19

Fotuhi, M., Mian, A., Meysami, S., & Raji, C. A. (2020). Neurobiology of COVID-19. Journal of Alzheimers Disease, 76(1), 3-19. doi:10.3233/jad-200581
https://content.iospress.com/articles/journal-of-alzheimers-disease/jad200581

Neurobiology of COVID-19

- Direct infection injury detected in tissue samples 
- Blood circulation pathway, entering the CNS through BBB
- Neuronal pathway (e.g. olfactory neuron transport) infecting sensory or motor nerve endings
- Hypoxia injury, damages caused by lack of oxygen circulation
- Immune injury-- systemic inflammatory response syndrome(SIRS)
- Affecting the ability of ACE2 enzyme to regulate blood pressure, damaging the BBB

Mechanisms of CoV infections on the nervous system damage

- Cerebrospinal fluid (CSF) (SARS/MERS)
- Olfactory bulb (SARS)
- Piriform and infra-limbic cortices (SARS)
- Ventral pallidum and lateral preoptic regions of the basal ganglia (SARS)
- Dorsal raphe (SARS)

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