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Applied Medical Research ISSN: 2149-2018
Applied Medical Research. 2021; 8(1):(99-120)


Brain and Peripheral Neuronal Injury in Covid-19: The Panorama and Dispute

Hayder M Al-kuraishy1*, Nawar R Hussien2, Marwa S Al-Niemi3 and Ali I Al-Gareeb

Abstract
Infection by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) coronavirus results in significant mortality and long-term disability. Coronavirus infectious disease 2019 (Covid-19), is caused by SARS-CoV-2 binds by glycoproteins expressed on its surface to the receptor of the angiotensin-converting enzyme 2 (ACE2), which is highly distributed in the respiratory tract epithelium. ACE2 is highly expressed on nervous tissue cells like neurons and astrocytes. Once inside the nerve cell, SARS-CoV-2 can alter the cellular transport function to facilitate its transmission from one neuron to another. Upon infection and because of other forms of damage neuroglial cells become reactive, representing the most classic neuro-pathological situation of the ongoing neuro-inflammation. Consequently, it is likely that the SARS‐CoV‐2 infected brain regions triggers reactive astrogliosis and activation of microglia. The mechanism of involvement of peripheral nervous system is not fully understood. It is mostly thought to be immune-mediated. In patients with rapid evolution of Guillain-Barrè syndrome (GBS) after the onset of COVID-19 symptoms, direct cytotoxic effects of virus on peripheral nerves is a postulated mechanism.