Impact of SARS-CoV-2 infection on neurodegenerative and neuropsychiatric diseases: a delayed pandemic?

Neurologia (Engl Ed). 2020 May;35(4):245-251. doi: 10.1016/j.nrl.2020.04.002. Epub 2020 Apr 17.
[Article in English, Spanish]

Abstract

Introduction: SARS-CoV-2 was first detected in December 2019 in the Chinese city of Wuhan and has since spread across the world. At present, the virus has infected over 1.7 million people and caused over 100 000 deaths worldwide. Research is currently focused on understanding the acute infection and developing effective treatment strategies. In view of the magnitude of the epidemic, we conducted a speculative review of possible medium- and long-term neurological consequences of SARS-CoV-2 infection, with particular emphasis on neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin, based on the available evidence on neurological symptoms of acute SARS-CoV-2 infection.

Development: We systematically reviewed the available evidence about the pathogenic mechanisms of SARS-CoV-2 infection, the immediate and lasting effects of the cytokine storm on the central nervous system, and the consequences of neuroinflammation for the central nervous system.

Conclusions: SARS-CoV-2 is a neuroinvasive virus capable of triggering a cytokine storm, with persistent effects in specific populations. Although our hypothesis is highly speculative, the impact of SARS-CoV-2 infection on the onset and progression of neurodegenerative and neuropsychiatric diseases of neuroinflammatory origin should be regarded as the potential cause of a delayed pandemic that may have a major public health impact in the medium to long term. Cognitive and neuropsychological function should be closely monitored in COVID-19 survivors.

Keywords: COVID-19; Cytokine storm; Enfermedades neurodegenerativas; Enfermedades neuropsiquiátricas; Neurodegenerative diseases; Neuroinflamación; Neuroinflammation; Neuropsychiatric diseases; SARS-CoV-2; Tormenta de citoquinas.

Publication types

  • Review

MeSH terms

  • Betacoronavirus / pathogenicity*
  • COVID-19
  • Coronavirus Infections / complications*
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / physiopathology
  • Cytokine Release Syndrome / etiology*
  • Cytokine Release Syndrome / physiopathology
  • Cytokine Release Syndrome / psychology
  • Cytokines / physiology*
  • Disease Progression
  • Humans
  • Immune System / physiopathology
  • Immune System / virology
  • Inflammation
  • Inflammation Mediators / physiology
  • Mental Disorders / epidemiology
  • Mental Disorders / etiology*
  • Models, Immunological
  • Models, Neurological
  • Neurodegenerative Diseases / epidemiology
  • Neurodegenerative Diseases / etiology*
  • Neuroimmunomodulation / physiology
  • Pandemics*
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / physiopathology
  • Public Health
  • SARS-CoV-2
  • Time Factors

Substances

  • Cytokines
  • Inflammation Mediators