Aspectos fisiopatológicos y manifestaciones neurológicas asociadas a la infección por SARSCoV-2/COVID-19.
Pathophysiologic aspects and neurological manifestations associated with SARS-CoV-2 infection/COVID-19.
Barra lateral del artículo
PDF
FLIP
Contenido principal del artículo
Resumen
Introducción: el SARS-CoV-2 representa al patógeno causante de la enfermedad denominada COVID-19. Dicha patología se ha extendido rápidamente a nivel mundial, constituyendo un importante problema de salud pública. Sus características clínicas no se limitan al tracto respiratorio, sino que también comprometen al sistema nervioso. Objetivo: identificar los posibles mecanismos directos e indirectos por los cuales el SARS-CoV-2 afecta al sistema nervioso y describir los eventos fisiopatológicos responsables de las manifestaciones y complicaciones neurológicas reportadas en COVID-19. Métodos: se realizó una revisión narrativa de la literatura encontrada en las bases de datos PubMed y Science Direct y en el motor de búsqueda Google Scholar utilizando las palabras claves. Se incluyeron artículos en idioma español e inglés publicados en el año 2020. Resultados: se identificaron los posibles mecanismos de invasión directa del SARSCoV-2 al SNC (por las propiedades neurotrópicas del virus) y los mecanismos indirectos (derivados de las alteraciones metabólicas, el estado proinflamatorio y la desregulación del sistema inmune) detrás del compromiso neurológico asociado a COVID-19. Conclusiones: la identificación de los posibles mecanismos que explican como el SARS-CoV-2 ingresa, se establece en el SNC y lo afecta directamente, así como su afectación indirecta, son un pilar fundamental para la comprensión de los eventos fisiopatológicos que explican las manifestaciones clínicas y complicaciones neurológicas reportadas en COVID-19.
Palabras clave:
Descargas
Detalles del artículo
Referencias (VER)
Pezzini A, Padovani A. Lifting the mask on neurological manifestations of COVID-19. Nat Rev Neurol. 2020; doi: https://doi.org/10.1038/s41582-020-0398-3
Vergara JP, Tolosa C. Covid 19: manifestaciones neurológicas. Acta Neurol Colomb. 2020; vol.36, suppl.1, pp.7-10. ISSN 0120-8748. Doi: https://doi.org/10.22379/24224022288
Tsivgoulis G, Palaiodimou L, Katsanos AH, Caso V, Köhrmann M, Molina C, et al. Neurological manifestations and implications of COVID-19 pandemic. Ther Adv Neurol Disord. 2020; 13:1756286420932036. doi: https://doi.org/10.1177/1756286420932036
Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020; 579(7798): 265-269. doi: https://doi.org/10.1038/s41586-020-2008-3
DosSantos MF, Devalle S, Aran V, Capra D, Roque NR, Coelho-Aguiar JM, et al. Neuromechanisms of SARS-CoV-2: A Review. Front Neuroanat. 2020; 14(37): 1-12. DOI: https://doi.org/10.3389/fnana.2020.00037
Gheblawi M, Wang K, Viveiros A, Nguyen Q, Zhong JC, Turner AJ, et al. Angiotensin-Converting Enzyme 2: SARS-CoV-2 Receptor and Regulator of the Renin-Angiotensin System: Celebrating the 20th Anniversary of the Discovery of ACE2. Circ Res. 2020; doi: https://doi.org/10.1161/CIRCRESAHA.120.317332
Baig AM, Khaleeq A, Ali U, Syeda H. Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host-Virus Interaction, and Proposed Neurotropic Mechanisms. ACS Chem Neurosci. 2020; 11(7): 995-998. doi: https://doi.org/10.1021/acschemneuro.0c00122
Pennisi M, Lanza G, Luca Falzone, Fisicaro F, Ferri R, Bella R. SARS-CoV-2 and the Nervous System: From Clinical Features to Molecular Mechanisms. Int J Mol Sci. 2020; 21(15): 5475. DOI: https://doi.org/10.3390/ijms21155475
Montalvan V, Lee J, Bueso T, De Toledo J, Rivas K. Neurological manifestations of COVID-19 and other coronavirus infections: A systematic review. Clinical Neurology and Neurosurgery. 2020; 194, 105921. doi: https://doi.org/10.1016/j.clineuro.2020.105921
Brann DH, Tsukahara T, Weinreb C, Lipovsek M, Van den Berge K, Gong B, et al. Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia. Sci Adv. 2020; 6(31): eabc5801. doi: https://doi.org/10.1126/sciadv.abc5801
Moriguchi T, Harii N, Goto J, Harada D, Sugawara H, Takamino J. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. 2020; 94: 55-58. doi: https://doi.org/10.1016/j.ijid.2020.03.062
Harapan H, Itoh N, Yufika A, Winardi W, Keam S, Te H, et al. Coronavirus disease 2019 (COVID-19): A literature review. J Infect Public Health. 2020; 13(5): 667-673. doi: https://doi.org/10.1016/j.jiph.2020.03.019
Abuabara E, Bohórquez J, Restom J, Sáenz J, Correa J, Mendoza C. Consideraciones actuales de antimaláricos en la infección por SARS-CoV-2 y su impacto. Rev. Colomb. Nefrol. 2020; doi: 10.22265/acnef.7.Supl%202.406
Sachdev K, Agrawal S, Ish P, Gupta N, Raheja K. Neurological manifestations of COVID-19: A brief review. Indian J Med Res. 2020; (1&2): 41-47. doi: https://doi.org/10.4103/ijmr.IJMR_1395_20
Carod-Artal FJ. Complicaciones neurológicas por coronavirus y COVID-19. Rev Neurol 2020; 70 (09): 311-322 doi: https://doi.org/10.33588/rn.7009.2020179
Aghagoli G, Gallo Marin B, Katchur NJ, Chaves-Sell F, Asaad WF, Murphy SA. Neurological Involvement in COVID-19 and Potential Mechanisms: A Review. Neurocrit Care. 2020; doi: https://doi.org/10.1007/s12028-020-01049-4
Abduljalil JM, Abduljalil BM. Epidemiology, genome, and clinical features of the pandemic SARS-CoV-2: a recent view. New Microbes New Infect. 2020; 35: 100672. doi: https://doi.org/10.1016/j.nmni.2020.100672
Deng YY, Zheng Y, Cai GY, Chen XM, Hong Q. Single-cell RNA sequencing data suggest a role for angiotensin-converting enzyme 2 in kidney impairment in patients infected with 2019-novel coronavirus. Chin Med J. 2020; 133(9): 1129-1131. doi: https://doi.org/10.1097/CM9.0000000000000783
Conde Cardona G, Quintana Pájaro LD, Quintero Marzola ID, Ramos Villegas Y, Moscote Salazar LR. Neurotropism of SARS-CoV 2: Mechanisms and manifestations. J Neurol Sci. 2020; 412: 116824. doi: https://doi.org/10.1016/j.jns.2020.116824
Moreno Zambrano D, Arévalo Mora M , Freire Bonifacini A, García Santibáñez R, Santibáñez Vásquez R. Manifestaciones Neurológicas Asociadas a la Infección Por SARS-CoV-2: Una Neuro-Revisión de COVID-19. Rev Ecuat Neurol. 2020; 29 (1): 115-124. https://doi.org/10.46997/revecuatneurol29100115
Orozco-Hernández JP, Marin-Medina DS, Sánchez-Duque JA. Manifestaciones neurológicas de la infección por SARS-CoV-2 [Neurological manifestations of SARS-CoV-2 infection]. Semergen. 2020; S1138-3593(20)30143-X. doi: https://doi.org/10.1016/j.semerg.2020.05.004
Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020. doi: https://doi.org/10.1002/jmv.25728
Zanin L, Saraceno G, Panciani PP, Renisi G, Signorini L, Migliorati K, et al. SARS-CoV-2 can induce brain and spine demyelinating lesions. Acta Neurochir. 2020; 162(7): 1491-1494. doi: https://doi.org/10.1007/s00701-020-04374-x
Guo YR, Cao QD, Hong ZS, Tan YY, Chen SD, Jin HJ. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak - an update on the status. Mil Med Res. 2020; 13; 7(1): 11. doi: https://doi.org/10.1186/s40779-020-00240-0
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020; (5): 475-481. doi: https://doi.org/10.1016/S2213-2600(20)30079-5
Karimi N, Sharifi Razavi A, Rouhani N. Frequent Convulsive Seizures in an Adult Patient with COVID-19: A Case Report, Iran Red Crescent Med J. 2020; 22(3): e102828. doi: https://doi.org/10.5812/ircmj.102828
Ye M, Ren Y, Lv T. Encephalitis as a clinical manifestation of COVID-19. Brain Behav Immun. 2020; 945-946. doi: https://doi.org/10.1016/j.bbi.2020.04.017
Mehta P, McAuley DF, Brown M, Sanchez E, Tattersall RS, Manson JJ; HLH Across Speciality Collaboration, UK. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020; 1033-1034. doi: https://doi.org/10.1016/S0140-6736(20)30628-0
Huang J, Zheng M, Tang X, Chen Y, Tong A, Zhou L. Potential of SARS-CoV-2 to Cause CNS Infection: Biologic Fundamental and Clinical Experience. Front Neurol. 2020; 11: 659. doi: https://doi.org/10.3389/fneur.2020.00659
Soler ZM, Patel ZM, Turner JH, Holbrook EH. A primer on viral-associated olfactory loss in the era of COVID-19. Int Forum Allergy Rhinol. 2020; 10(7): 814-820. doi: https://doi.org/10.1002/alr.22578
Vaira LA, Salzano G, Fois AG, Piombino P, De Riu G. Potential pathogenesis of ageusia and anosmia in COVID-19 patients. Int Forum Allergy Rhinol. 2020; 10(9): 1103-1104. doi: https://doi.org/10.1002/alr.22593
Poyiadji N, Shahin G, Noujaim D, Stone M, Patel S, Griffith B. COVID-19-associated Acute Hemorrhagic Necrotizing Encephalopathy: Imaging Features. Radiology. 2020; 296(2): E119-E120. doi: https://doi.org/10.1148/radiol.2020201187
Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, et al. Neurologic Manifestations of Hospitalized Patients with Coronavirus Disease 2019 in Wuhan, China. JAMA Neurol. 2020; 77(6): 1-9. doi: https://doi.org/10.1001/jamaneurol.2020.1127
Helms J, Kremer S, Merdji H, et al. Neurologic Features in Severe SARS-CoV-2 Infection. N Engl J Med. 2020; 382(23): 2268-2270. doi: https://doi.org/10.1056/NEJMc2008597
Ahmad I, Rathore FA. Neurological manifestations and complications of COVID-19: A literature review. J Clin Neurosci. 2020; 77: 8-12. DOI: https://doi.org/10.1016/j.jocn.2020.05.017
Deng Y, Liu W, Liu K, Fang YY, Shang J, Zhou L. Clinical characteristics of fatal and recovered cases of coronavirus disease 2019 in Wuhan, China: a retrospective study. Chin Med J. 2020; 133(11): 1261-1267. doi: https://doi.org/10.1097/CM9.0000000000000824
Filatov A, Sharma P, Hindi F, et al. Neurological Complications of Coronavirus Disease (COVID-19): Encephalopathy. Cureus. 2020; 12(3): e7352. doi: https://doi.org/10.7759/cureus.7352
Chen T, Wu D, Chen H, Yan W, Yang D, Chen G. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. BMJ. 2020; 368: m1091. doi: https://doi.org/10.1136/bmj.m1091
Jasti M, Nalleballe K, Dandu V, Onteddu S. A review of pathophysiology and neuropsychiatric manifestations of COVID-19. J Neurol. 2020; 1-6. doi: https://doi.org/10.1007/s00415-020-09950-w
Ellul MA, Benjamin L, Singh B, Lant S, Michael BD, Easton A, et al. Neurological associations of COVID-19. Lancet Neurology. 2020; 19(9): 767-783. doi: https://doi.org/10.1016/S1474-4422(20)30221-0
Saleki K, Banazadeh M, Saghazadeh A, Rezaei N. The involvement of the central nervous system in patients with COVID-19. Rev Neurosci. 2020; 31(4): 453-456. doi: https://doi.org/10.1515/revneuro-2020-0026
Sotoca J, Rodríguez-Álvarez J. COVID-19-associated acute necrotizing myelitis. Neurol Neuroimmunol Neuroinflamm. 2020; 7 (5) e803; doi: https://doi.org/10.1212/NXI.0000000000000803
Durrani M, Kucharski K, Smith Z, Fien S. Acute Transverse Myelitis Secondary to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): A Case Report. Clin Pract Cases Emerg Med. 2020; 4(3): 344-348. doi: https://doi.org/10.5811/cpcem.2020.6.48462
Zhao H, Shen D, Zhou H, Liu J, Chen S. Guillain-Barre syndrome associated with SARS-CoV-2 infection: causality or coincidence?. Lancet Neurol. 2020; doi: https://doi.org/10.1016/S1474-4422(20)30109-5
AlKetbi R, AlNuaimi D, AlMulla M, et al. Acute myelitis as a neurological complication of Covid-19: A case report and MRI findings. Radiol Case Rep. 2020; 15(9): 1591-1595. Published 2020 Jun 6. doi: https://doi.org/10.1016/j.radcr.2020.06.001
Sarma D, Bilello LA. A Case Report of Acute Transverse Myelitis Following Novel Coronavirus Infection. Clin Pract Cases Emerg Med. 2020; 4(3): 321-323. doi: https://doi.org/10.5811/cpcem.2020.5.47937
Sharifi-Razavi A, Karimi N, Rouhani N. COVID-19 and intracerebral haemorrhage: causative or coincidental?. New Microbes New Infect. 2020; 35: 100669. doi: https://doi.org/10.1016/j.nmni.2020.100669
Fan H, Tang X, Song Y, Liu P, Chen Y. Influence of COVID-19 on Cerebrovascular Disease and its Possible Mechanism. Neuropsychiatr Dis Treat. 2020; 16: 1359-1367. doi: https://doi.org/10.2147/NDT.S251173
Sharifian-Dorche M, Huot P, Osherov M, Wen D, Saveriano A, Giacomini PS, et al. Neurological complications of coronavirus infection; a comparative review and lessons learned during the COVID-19 pandemic. J Neurol Sci. 2020. 15; 417: 117085. doi: https://doi.org/10.1016/j.jns.2020.117085
Trejos-Gabriel JM. Stroke as a complication and prognostic factor of COVID-19. Neurologia. 2020; 35(5): 318-322. doi: https://doi.org/10.1016/j.nrleng.2020.04.013
Yan CH, Faraji F, Prajapati DP, Boone CE, DeConde AS. Association of chemosensory dysfunction and COVID-19 in patients presenting with influenza-like symptoms. Int Forum Allergy Rhinol. 2020; 10(7): 806-813. doi: https://doi.org/10.1002/alr.22579
Bagheri SH, Asghari A, Farhadi M, Shamshiri AR, Kabir A, Kamrava SK, et al. Coincidence of COVID-19 epidemic and olfactory dysfunction outbreak in Iran. Med J Islam Repub Iran. 2020; doi: https://doi.org/10.47176/mjiri.34.62
Redondo-Urda MJ, Rodríguez-Peguero FJ, Pérez-Gil O, Del Valle-Sánchez M, Carrera-Izquierdo M. SARS-CoV-2, nuevo agente causal del síndrome de Guillain-Barré [SARS-CoV-2, a new causal agent of Guillain-Barre syndrome]. Rev Neurol. 2020; 71(7): 275-276. doi: https://doi.org/10.33588/rn.7107.2020264
Virani A, Rabold E, Hanson T, Haag A, Elrufay R, Cheema T, et al. Guillain-Barré Syndrome associated with SARS-CoV-2 infection. ID Cases. 2020; 20: e00771. doi: https://doi.org/10.1016/j.idcr.2020.e00771
Sedaghat Z, Karimi N. Guillain Barre syndrome associated with COVID-19 infection: A case report. J Clin Neurosci. 2020 Jun; 76: 233-235. doi: https://doi.org/10.1016/j.jocn.2020.04.062
Toscano G, Palmerini F, Ravaglia S, Ruiz L, Invernizzi P, Cuzzoni MG, et al. Guillain-Barré Syndrome Associated with SARS-CoV-2. N Engl J Med. 2020; doi: https://doi.org/10.1056/NEJMc2009191
Jin M, Tong Q. Rhabdomyolysis as Potential Late Complication Associated with COVID-19. Emerg Infect Dis. 2020; 26(7): 10.3201/eid2607.200445. doi: https://doi.org/10.3201/eid2607.200445
Gutiérrez-Ortiz C, Méndez A, Rodrigo-Rey S, San Pedro-Murillo E, Bermejo-Guerrero L, Gordo-Mañas R, et al. Miller Fisher Syndrome and polyneuritis cranialis in COVID-19. Neurology. 2020; doi: https://doi.org/10.1212/WNL.0000000000009619
Wan Y, Cao S, Fang Q, Wang M, Huang Y. Coronavirus disease 2019 complicated with Bell's palsy: a case report. Research Square. 2020. DOI: https://doi.org/10.21203/rs.3.rs-23216/v1
Rahman MM, Azam MG, Bohorquez-Rivero J, Garcia-Ballestas E, Agrawal, Moscote-Salazar LR. Telehealth and telemedicine in the COVID-19 era: a world of opportunities for the neurosurgeons. World Neurosurg. 2020; doi: https://doi.org/10.1016/j.wneu.2020.06.064
Lyden P. AHA/ASA Stroke Council Leadership. Temporary emergency guidance to US stroke centers during the COVID-19 pandemic on behalf of the AHA/ASA stroke council leadership. Stroke. 2020; doi: https://doi.org/10.1161/STROKEAHA.120.030023
Khosravani H, Rajendram P, Notario L, Chapman MG, Menon BK. Protected Code Stroke: Hyperacute Stroke Management During the Coronavirus Disease 2019 (COVID-19) Pandemic. Stroke. 2020; doi: https://doi.org/10.1161/STROKEAHA.120.029838
