Review of the pathogenesis, clinical manifestations and peculiarities of neuropsychic disorders caused by COVID-19
Abstract
The article presents literature data numerous studies of patients with COVID-19. The available information helps to explain the nature
and structure of the virus, the ways of penetration and its distribution in the human body, its interaction with the immune, nervous,
endocrine, vascular, muscular systems, as well as the pathogenesis, clinic, diagnosis and treatment of this contingent of patients. Due
to tropisms SARS-CoV-2 to the human cells specifi c S glycoprotein this virus can bind receptor human angiotensin-converting enzyme
2 (ACE-2), fuse with host cells and disseminate in the organism. Renin-angiotensin-aldosteron system (RAAS) plays an important role
in regulation of blood vessels, heart, kidneys functions. ACE-2 has an infl uence on the infl ammatory, fi brotic and immunomodulatory
mechanisms. Inhibition of these protection functions due to spread SARS-CoV-2 in human body leads to the progression of cardiovascular,
renal and pulmonary diseases. Some authors describe indirectly the viral entry into the brain parenchyma by infecting the T-lymphocytes,
that usually is accompanied by infl ammatory reactions with an increase in the specifi c cytokines such as interleukins (IL) — 6, IL-8, tumor
necrosis factor, monocyte chemoattractant protein-1 (MCP-1). The peculiarities of the binding of the virus to the human cells are the
presence of neurotropic properties and the ability to change the permeability of blood brain barier (BBB). Other authors note that the
virus crosses the BBB directly through the olfactory neurons and also the brain’s circumventricular organs structures, surrounding the third
and fourth ventricles, and promote the infection of nervous system. It can also cause intravascular coagulation and blood clotting, which
may lead to various diseases of the nervous system. In this regard, an important task for neurologists is to further study the eff ect of the
COVID-19 virus on the nervous system and prevent the occurrence of its complications.
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References
Chen Y., Guo Y., Pan Y. [et al.]. Structure analysis of the receptor binding of 2019-nCoV. Biochem Biophys Res Commun. 2020. No. 525(1), pp. 135–140. https://www.doi.org/10.1016/j.bbrc.2020.02.071
Zhou P., Yang X. L., Wang X. G. [et al.]. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020. No. 579(7798), pp. 270–273. https://www.doi.org/10.1038/s41586-020-2012-7
Coronaviridae Study Group of the International Committee on Taxonomy of Viruses 2020; Weiss and Navas-Martin 2005.
Rothan H. A., Byrareddy S. N. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun. 2020. No. 109, p. 102433. https://www.doi.org/10.1016/j.jaut.2020.102433
Haidar A., Jourdi H., Haj Hassan Z. [et al.]. Neurological and neuropsychological changes associated with SARS-CoV-2 infection: new observation, new mechanisms. Review. The neuroscientist. 2021, p. 20. https://www.doi.org/10.1177/1073858420984106
Coutard B., Valle C., de Lamballerie X. [et al.]. The spike glycoprotein of the new coronavirus 2019-nCoV contains a furin-like cleavage site absent in CoV of the same clade. Antiviral Research. 2020. No. 176, p. 104742. https://www.doi.org/10.1016/j.antiviral.2020.104742
Bosch B. J., van der Zee R., de Haan C. A. [et al.]. The coronavirus spike protein is a class I virus fusion protein: structural and functional characterization of the fusion core complex. J Virol. 2003. No. 77(16), pp. 8801–8811.
Walls A. C., Tortorici M. A., Snijdera J. [et al.]. Tectonic conformational changes of a coronavirus spike glycoprotein promote membrane fusion. Proc Natl Acad Sci U.S.A. 2017. No. 114(42), pp. 11157–11162.
Moriguchi T., Harii N., Goto J. [et al.]. A fi rst case of meningitis/encephalitis associated with SARS-coronavirus-2. Int J Infect Dis. 2020. No. 94, pp. 55–58. https://www.doi.org/10.1016/j.ijid.2020.03.062
Almeida L. F., Tofteng S. S., Madsen K. [et al.]. Role of the renin-angiotensin system in kidney development and programming of adult blood pressure. Clin Sci (Lond). 2020. No. 134(6), pp. 641–656. https://www.doi.org/10.1042/CS20190765
Rodrigues Prestes T. R., Rocha N. P., Miranda A. S. [et al.]. The antiinfl ammatory potential of ACE2/angiotensin-(1-7)/Mas receptor axis: evidence from basic and clinical research. Curr Drug Targets. 2017. No. 18(11), pp. 1301–1313. https://www.doi.org/10.2174/1389450117666160727142401
Zhao H., Shen D., Zhou H. [et al.]. Guillain-Barré syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol. 2020. No. 19(5), pp. 383–384. https://doi.org/10.1016/S1474-4422(20)30109-5
Yuanyuan Li, Haipeng Li, Ruyan Fan [at el.]. Coronavirus Infections in Central Nervous System and Respiratory Tract Show Distinct Features in Hospitalized Children // Intervirology. 2016. No. 59, pp. 163–169. https://doi.org/10.1159/000453066
Divani A. A., Andalib S., Di Napoli M. [et al.]. Coronavirus disease 2019 and stroke: clinical manifestations and pathophysiological insights. J Stroke Cerebrovasc Dis. 2020. No. 29(8), p. 104941. https://doi.org/10.1016/j.jstrokecerebrovasdis.2020.104941
Xinhua News Agency. 2020. Beijing hospital confi rms nervous system infections by novel coronavirus.
Fitzgerald S. 2020. The spread of COVID-19: questions raised, some answered by neuroinfectious disease experts. Neurology Today. 2020.
Rogers J. P., Chesney E., Oliver D. [et al.]. Psychiatric and neuropsychiatric syndromes and COVID-19 – Authors’ reply. Lancet Psychiatry. 2020. No. 7(8), pp. 664–665. https://doi.org/10.1016/S2215-0366(20)30304-7
Poyiadji N., Shahin G., Noujaim D. [et al.]. COVID-19-associated acute hemorrhagic necrotizing encephalopathy: imaging features. Radiology. 2020. No. 296(2), pp. 119–120. https://doi.org/10.1148/radiol.2020201187
Stetka B. S. 2020. What neurologists can expect from COVID-19. Medscape.
Varatharaj A., Thomas N., Ellul M.A. [et al.]. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study. Lancet Psychiatry. 2020. No. 7(10), pp. 875–882. https://doi.org/10.1016/S2215-0366(20)30287-X
Boehme A. K., Luna J., Kulick E. R. [et al.]. Infl uenza-like illness as a trigger for ischemic stroke. Ann Clin Transl Neurol. 2018. No. 5(4), pp. 456–463. https://doi.org/10.1002/acn3.545
Lam M. H., Wing Y. K., Yu M. W. [et al.]. Mental morbidities and chronic fatigue in severe acute respiratory syndrome survivors: long-term follow-up. Arch Intern Med 2009. No. 169(22), pp. 2142–2147. https://doi.org/10.1001/archinternmed.2009.384
Delorme C., Paccoud O., Kas S. [et al.]. Neurosciences study group and COVID SMIT PSL study group Eur J Neurol. 2020. No. (12), pp. 2651-2657.
Orsucci D, Caldarazzo Ienco E., Nocita G. [et al.]. Neurological features of COVID-19 and their treatment: a review. Drugs in Contex.t 2020. No. 9. https://doi.org/10.7573/dic.2020-5-1
Mishchenko T., Mishchenko V. Neurological complications in patient with COVID-19. Psychiatry, Neurology and Medical Psychology. 2021. No. 16, pp. 23-33. [In Ukr.]. https://doi.org/10.26565/2312-5675-2021-16-03
Lodigiani C, Iapichino G, Carenzo L, et al. Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan, Italy. Thromb Res. 2020. No. 191, pp. 9–14. https://doi.org/10.1016/j.thromres.2020.04.024
Jain R, Young M, Dogra S, [et al.]. COVID-19 related neuroimaging fi ndings: a signal of thromboembolic complications and a strong prognostic marker of poor patient outcome. J Neurol Sci. 2020. No. 414, p.116923
Centers for Disease Control and Prevention. COVID-19: how to protect yourself & others. 2021. Available at: https://www.cdc.gov/coronavirus/2019-ncov/preventgetting-sick/prevention.html.
Centers for Disease Control and Prevention. COVID-19: if you are sick or caring for someone. 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/if-youare-sick/.
Beigel J. H., Tomashek K. M., Dodd L. E., [et al.]. Remdesivir for the treatment of COVID-19 – fi nal report. N Engl J Med. 2020. No. 383(19), pp. 1813-1826. https://doi.org/10.1056/NEJMoa2007764
Wang Y., Zhang D., Du G., [et al.]. Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. Lancet. 2020. No. 395(10236), pp. 1569-1578. https://doi.org/10.1016/S0140-6736(20)31022-9
Spinner C. D., Gottlieb R. L., Criner G. J., [et al.]. Eff ect of remdesivir vs standard care on clinical status at 11 days in patients with moderate COVID-19: a randomized clinical trial. JAMA. 2020. No. 324(11), pp. 1048-1057. https://doi.org/10.1001/jama.2020.16349
Goldman J. D., Lye D. C. B., Hui D. S., [et al.]. Remdesivir for 5 or 10 days in patients with severe COVID-19. N Engl J Med. 2020. No. 383(19), pp. 1827-1837. https://doi.org/10.1056/NEJMoa2015301
RECOVERY Collaborative Group, Horby P, Lim WS, [et al.]. Dexamethasone in hospitalized patients with COVID-19 – preliminary report. N Engl J Med. 2020. No. 384(8), pp. 693-704. https://doi.org/10.1056/NEJMoa2021436
Jeronimo C. M. P., Farias M. E. L., Val F. F. A., [et al.]. Methylprednisolone as adjunctive therapy for patients hospitalized with COVID-19 (Metcovid): a randomised, double-blind, Phase IIb, placebo-controlled trial. Clin Infect Dis. 2020. https://doi.org/10.1093/cid/ciaa1177
Tomazini B. M., Maia I. S., Cavalcanti A. B., [et al.]. Eff ect of dexamethasone on days alive and ventilator-free in patients with moderate or severe acute respiratory distress syndrome and COVID-19: the CoDEX randomized clinical trial. JAMA. 2020. No. 324(13), pp. 1307-1316. https://doi.org/10.1001/jama.2020.17021
Angus D. C., Derde L., Al-Beidh F., [et al.]. Eff ect of hydrocortisone on mortality and organ support in patients with severe COVID-19: the REMAP-CAP COVID-19 corticosteroid domain randomized clinical trial. JAMA. 2020. No. 324(13), pp. 1317-1329. https://doi.org/10.1001/jama.2020.17022
Gordon A. C., Mouncey P. R., Al-Beidh F., [et al.]. Interleukin-6 receptor antagonists in critically ill patients with COVID-19. N Engl J Med. 2021. https://doi.org/10.1056/NEJMoa2100433
Horby P. W., Pessoa-Amorim G., Peto L., [et al.]. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY): preliminary results of a randomised, controlled, open-label, platform trial. medRxiv. 2021. https://doi.org/10.1101/2021.02.11.21249258
