All these features may contribute to a relatively high clinical prevalence of COVID-19-associated CNS complications.Ī wide variety of neurological syndromes have been reported in COVID-19 cases, including encephalitis, encephalopathy, stroke, ADEM, reversible posterior leukoencephalopathy, optic neuritis, and epilepsy, among other. The excessive systemic inflammatory response caused by innate immune maladaptation can damage the function of the CNS by impairing the function of neurovascular endothelial cells, activating the CNS innate immune signalling pathway, and inducing autoimmunity. According to prior research, SARS-CoV-2 infection can activate the innate immune response uncontrollably while impairing adaptive immunity. found that ACE2 is expressed in many neurons and some non-neuronal cells (mainly astrocytes, oligodendrocytes, and neurovascular endothelial cells) of the brain, which makes the CNS a target organ for SARS-CoV-2. ACE2 is widely distributed in vascular endothelial cells and arterial smooth muscle cells of human organs. SARS-CoV-2 shares 79.5% of its sequence with SARS-CoV, but its affinity for angiotensin-converting enzyme-2 (ACE2) is 10–20 times higher than that of SARS. In contrast to the six other coronavirus subtypes, SARS-CoV-2 is classified as a β-coronavirus. The remaining three coronaviruses can lead to a severe acute respiratory disease pandemic: SARS-CoV, which caused the SARS outbreak MERS-CoV, which caused Middle East respiratory syndrome (MERS) and SARS-CoV-2, which is currently causing COVID-19. There are seven coronaviruses currently known to cause disease in humans, and four of them-229E, OC43, NL63 and HKU1-usually cause mild seasonal respiratory symptoms in humans. All patients signed written informed consent respectively. The study complied with the Declaration of Helsinki and was approved by the Ethics Committee of the Eighth Affiliated Hospital, Sun Yat-Sen University. Finally, the CNS complications occurred within 6 weeks post-COVID-19 infection. While cerebrovascular diseases were not included in this study. Second, the patients had CNS complications such as meningitis, encephalitis (including encephalopathy), ADEM, or myelitis. First, the patients met the WHO COVID-19 case definitions or the diagnostic criteria for novel coronavirus infection in the “Novel Coronavirus Infection Diagnosis and Treatment Protocol (Trial Version 10)” issued by the National Health Commission of the People's Republic of China in 2023. For this single-centre observation study, we recruited patients with COVID-19-associated CNS complications from all COVID-19 patients admitted to the neurology inpatient department of the Eighth Affiliated Hospital, Sun Yat-Sen University (Futian, Shenzhen) during the Omicron pandemic wave from Dec 2022 to Feb 2023.
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