Persistent COVID-19 on CNS: A Consequence of an Infection or a Persistent Quiescent Infection?

A special issue of Pathogens (ISSN 2076-0817). This special issue belongs to the section "Viral Pathogens".

Deadline for manuscript submissions: closed (15 October 2022) | Viewed by 4763

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Department of Neurology, Institute of Neurosciences, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdISSC), Universidad Complutense de Madrid, Madrid, Spain
Interests: multiple sclerosis; neurodegenerative diseases; neural repair; neuromolecular mechanisms; long COVID
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Laboratory of Neurobiology, Institute of Neurosciences, IdISSC, Hospital Clínico San Carlos, Universidad Complutense de Madrid, 28040 Madrid, Spain
Interests: ALS; MS; cerebrovascular pathologies; stroke
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Department of Neurology, Institute of Neurosciences, Hospital Clinico San Carlos, San Carlos Institute for Health Research (IdISSC), Universidad Complutense de Madrid, 28223 Madrid, Spain
Interests: Alzheimer disease; neurodegenerative diseases; cognition; cognitive post-COVID-19 disease; neuroimaging
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Medical and Pharmaceutical Biotechnology Unit, Center of Research and Assistance in Technology and Design of the State of Jalisco, Guadalajara 44270, Mexico
Interests: neural repair; stem cells therapy; biomaterials; experimental models; central nervous system
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Department of Microbiology, Hospital Clinico San Carlos, Instituto de Investigación Sanitaria San Carlos (IdISSC) Madrid, Spain
Interests: SARS-Cov2; viruses; infection; virological research

Special Issue Information

Dear Colleagues,

A Delphy study carried out within the framework of the WHO has recently established the criteria to define prolonged clinical conditions after infection by SARS-Cov2. These clinical syndromes have received different names such as post-COVID-19 syndrome, persistent COVID-19, or long COVID. These conditions predominately show symptoms that are associated with the CNS, such as headache, fatigue, or  cognitive alterations.

Different studies have analyzed the potential presence of SARS-Cov2 in the CNS, especially discussing the routes of entry. However, the information on whether the virus or its RNA can persist is much less, although it is known that various types of coronavirus have been found in the brain of patients who have presented multiple sclerosis or neurological diseases.

The debate is still open on whether the brain can be a reservoir of the virus, and whether this can be more evident in those subjects who have presented a lower discharge of inflammatory cytokines. Likewise, whether the presence of the virus or its RNA can predispose to neurodegenerative diseases has also been suggested.

Knowing whether patients with persistent COVID-19 or long COVID are the consequence of an acute infection or due to the persistence of the virus in a inactive state is an unanswered question with implications on many aspects.

This Special Issue aims for authors and researchers to participate in this debate with contributions both in the form of opinions and articles that show evidence that leads to a better understanding of the mechanisms that sustain persistent COVID-19 in its relationship with the CNS.

Dr. Jorge Matias-Guiu
Dr. Ulises Gomez‐Pinedo 
Dr. Jordi A. Matias-Guiu 
Dr. Alejandro Arturo Canales-Aguirre
Dr. Alberto Delgado-Iribarren 
Guest Editors

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Keywords

  • SARS-Cov2
  • persistent COVID-19 diseases
  • long COVID
  • central nervous system
  • persistent infection

Published Papers (2 papers)

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11 pages, 1093 KiB  
Review
Approximations to Diagnosis and Therapy of COVID-19 in Nervous Systems Using Extracellular Vesicles
by Karen Rojas, Maritza G. Verdugo-Molinares, Andrea G. Ochoa-Ruiz, Alejandro Canales, Edwin E. Reza-Zaldivar, Areli Limón-Rojas and Alba Adriana Vallejo-Cardona
Pathogens 2022, 11(12), 1501; https://doi.org/10.3390/pathogens11121501 - 08 Dec 2022
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Abstract
The SARS-CoV-2 virus was first identified at the end of December 2019, causing the disease known as COVID-19, which, due to the high degree of contagion, was declared a global pandemic as of 2020. The end of the isolation was in 2022, thanks [...] Read more.
The SARS-CoV-2 virus was first identified at the end of December 2019, causing the disease known as COVID-19, which, due to the high degree of contagion, was declared a global pandemic as of 2020. The end of the isolation was in 2022, thanks to the global multidisciplinary work of the massive vaccination campaigns. Even with the current knowledge about this virus and the COVID-19 disease, there are many questions and challenges regarding diagnosis and therapy in the fight against this virus. One of the big problems is the so-called "long COVID", prolonged symptomatology characterized as a multiorgan disorder manifested as brain fog, fatigue, and shortness of breath, which persist chronically after the disease resolution. Therefore, this review proposes using extracellular vesicles (EVs) as a therapeutic or diagnostic option to confront the sequelae of the disease at the central nervous system level. Development: the review of updated knowledge about SARS-CoV-2 and COVID-19 is generally addressed as well as the current classification of extracellular vesicles and their proposed use in therapy and diagnosis. Through an analysis of examples, extracellular vesicles are highlighted to learn what happens in the central nervous system during and after COVID-19 and as a therapeutic option. Conclusions: even though there are limitations in the knowledge of the neurological manifestations of COVID-19, it is possible to observe the potential use of extracellular vesicles in therapy or as a diagnostic method and even the importance of their study for the knowledge of the pathophysiology of the disease Full article
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9 pages, 1442 KiB  
Case Report
Intracranial Aneurysm Rupture after SARS-CoV2 Infection: Case Report and Review of Literature
by Dilaware Khan, Soheil Naderi, Mostafa Ahmadi, Askar Ghorbani, Jan Frederick Cornelius, Daniel Hänggi and Sajjad Muhammad
Pathogens 2022, 11(6), 617; https://doi.org/10.3390/pathogens11060617 - 24 May 2022
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Abstract
Background: SARS-CoV virus infection results in a dysbalanced and severe inflammatory response with hypercytokinemia and immunodepression. Viral infection triggers systemic inflammation and the virus itself can potentially cause vascular damage, including blood–brain barrier (BBB) disruption and alterations in the coagulation system, which may [...] Read more.
Background: SARS-CoV virus infection results in a dysbalanced and severe inflammatory response with hypercytokinemia and immunodepression. Viral infection triggers systemic inflammation and the virus itself can potentially cause vascular damage, including blood–brain barrier (BBB) disruption and alterations in the coagulation system, which may result in cardiovascular and neurovascular events. Here, we review the literature and present a case of COVID-19 infection leading to an aneurysmal subarachnoid haemorrhage (aSAH). Case Description: A 61-year-old woman presented with dyspnea, cough, and fever. She had a history of hypertension and was overweight with a body mass-index of 34. There was no history of subarachnoid hemorrhage in the family. Due to low oxygen saturation (89%) she was admitted into ICU. A chest CT showed a typical picture of COVID-19 pneumonia. The PCR-based test of an oropharyngeal swab was COVID-19-positive. In addition to oxygen support she was prescribed with favipiravir and hydroxychloroquine. She experienced a sudden headache and lost consciousness on the second day. Computer tomography (CT) with CT-angiography revealed a subarachnoid haemorrhage in the basal cisterns from a ruptured anterior communicating artery aneurysm. The aneurysm was clipped microsurgically through a left-sided standard pterional approach and the patient was admitted again to the intensive care unit for further intensive medical treatment. Post-operatively, the patient showed slight motor dysphasia. No other neurological deficits. Conclusion: Systemic inflammation and ventilator support-associated blood pressure fluctuations may trigger aneurysmal subarachnoid haemorrhage secondary to COVID-19 infection. COVID-19 infection could be considered as one of the possible risk factors leading to instability and rupture of intracranial aneurysm. Full article
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