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SARS-CoV-2 and the Brain: What Do We Know about the Causality of ‘Cognitive COVID?

The second year of the COVID-19 (coronavirus disease) pandemic has seen the need to identify and assess the long-term consequences of a SARS-CoV-2 infection on an individual’s overall wellbeing, including adequate cognitive functioning. ‘Cognitive COVID’ is an informal term coined to interchangeably...

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Autores principales: Ali Awan, Hashir, Najmuddin Diwan, Mufaddal, Aamir, Alifiya, Ali, Muneeza, Di Giannantonio, Massimo, Ullah, Irfan, Shoib, Sheikh, De Berardis, Domenico
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347421/
https://www.ncbi.nlm.nih.gov/pubmed/34362224
http://dx.doi.org/10.3390/jcm10153441
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author Ali Awan, Hashir
Najmuddin Diwan, Mufaddal
Aamir, Alifiya
Ali, Muneeza
Di Giannantonio, Massimo
Ullah, Irfan
Shoib, Sheikh
De Berardis, Domenico
author_facet Ali Awan, Hashir
Najmuddin Diwan, Mufaddal
Aamir, Alifiya
Ali, Muneeza
Di Giannantonio, Massimo
Ullah, Irfan
Shoib, Sheikh
De Berardis, Domenico
author_sort Ali Awan, Hashir
collection PubMed
description The second year of the COVID-19 (coronavirus disease) pandemic has seen the need to identify and assess the long-term consequences of a SARS-CoV-2 infection on an individual’s overall wellbeing, including adequate cognitive functioning. ‘Cognitive COVID’ is an informal term coined to interchangeably refer to acute changes in cognition during COVID-19 and/or cognitive sequelae with various deficits following the infection. These may manifest as altered levels of consciousness, encephalopathy-like symptoms, delirium, and loss of various memory domains. Dysexecutive syndrome is a peculiar manifestation of ‘Cognitive COVID’ as well. In the previous major outbreaks of viruses like SARS-CoV, MERS-CoV and Influenza. There have been attempts to understand the underlying mechanisms describing the causality of similar symptoms following SARS-CoV-2 infection. This review, therefore, is attempting to highlight the current understanding of the various direct and indirect mechanisms, focusing on the role of neurotropism of SARS-CoV-2, the general pro-inflammatory state, and the pandemic-associated psychosocial stressors in the causality of ‘Cognitive COVID.’ Neurotropism is associated with various mechanisms including retrograde neuronal transmission via olfactory pathway, a general hematogenous spread, and the virus using immune cells as vectors. The high amounts of inflammation caused by COVID-19, compounded with potential intubation, are associated with a deleterious effect on the cognition as well. Finally, the pandemic’s unique psychosocial impact has raised alarm due to its possible effect on cognition. Furthermore, with surfacing reports of post-COVID-vaccination cognitive impairments after vaccines containing mRNA encoding for spike glycoprotein of SARS-CoV-2, we hypothesize their causality and ways to mitigate the risk. The potential impact on the quality of life of an individual and the fact that even a minor proportion of COVID-19 cases developing cognitive impairment could be a significant burden on already overwhelmed healthcare systems across the world make it vital to gather further evidence regarding the prevalence, presentation, correlations, and causality of these events and reevaluate our approach to accommodate early identification, management, and rehabilitation of patients exhibiting cognitive symptoms.
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spelling pubmed-83474212021-08-08 SARS-CoV-2 and the Brain: What Do We Know about the Causality of ‘Cognitive COVID? Ali Awan, Hashir Najmuddin Diwan, Mufaddal Aamir, Alifiya Ali, Muneeza Di Giannantonio, Massimo Ullah, Irfan Shoib, Sheikh De Berardis, Domenico J Clin Med Review The second year of the COVID-19 (coronavirus disease) pandemic has seen the need to identify and assess the long-term consequences of a SARS-CoV-2 infection on an individual’s overall wellbeing, including adequate cognitive functioning. ‘Cognitive COVID’ is an informal term coined to interchangeably refer to acute changes in cognition during COVID-19 and/or cognitive sequelae with various deficits following the infection. These may manifest as altered levels of consciousness, encephalopathy-like symptoms, delirium, and loss of various memory domains. Dysexecutive syndrome is a peculiar manifestation of ‘Cognitive COVID’ as well. In the previous major outbreaks of viruses like SARS-CoV, MERS-CoV and Influenza. There have been attempts to understand the underlying mechanisms describing the causality of similar symptoms following SARS-CoV-2 infection. This review, therefore, is attempting to highlight the current understanding of the various direct and indirect mechanisms, focusing on the role of neurotropism of SARS-CoV-2, the general pro-inflammatory state, and the pandemic-associated psychosocial stressors in the causality of ‘Cognitive COVID.’ Neurotropism is associated with various mechanisms including retrograde neuronal transmission via olfactory pathway, a general hematogenous spread, and the virus using immune cells as vectors. The high amounts of inflammation caused by COVID-19, compounded with potential intubation, are associated with a deleterious effect on the cognition as well. Finally, the pandemic’s unique psychosocial impact has raised alarm due to its possible effect on cognition. Furthermore, with surfacing reports of post-COVID-vaccination cognitive impairments after vaccines containing mRNA encoding for spike glycoprotein of SARS-CoV-2, we hypothesize their causality and ways to mitigate the risk. The potential impact on the quality of life of an individual and the fact that even a minor proportion of COVID-19 cases developing cognitive impairment could be a significant burden on already overwhelmed healthcare systems across the world make it vital to gather further evidence regarding the prevalence, presentation, correlations, and causality of these events and reevaluate our approach to accommodate early identification, management, and rehabilitation of patients exhibiting cognitive symptoms. MDPI 2021-08-02 /pmc/articles/PMC8347421/ /pubmed/34362224 http://dx.doi.org/10.3390/jcm10153441 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Ali Awan, Hashir
Najmuddin Diwan, Mufaddal
Aamir, Alifiya
Ali, Muneeza
Di Giannantonio, Massimo
Ullah, Irfan
Shoib, Sheikh
De Berardis, Domenico
SARS-CoV-2 and the Brain: What Do We Know about the Causality of ‘Cognitive COVID?
title SARS-CoV-2 and the Brain: What Do We Know about the Causality of ‘Cognitive COVID?
title_full SARS-CoV-2 and the Brain: What Do We Know about the Causality of ‘Cognitive COVID?
title_fullStr SARS-CoV-2 and the Brain: What Do We Know about the Causality of ‘Cognitive COVID?
title_full_unstemmed SARS-CoV-2 and the Brain: What Do We Know about the Causality of ‘Cognitive COVID?
title_short SARS-CoV-2 and the Brain: What Do We Know about the Causality of ‘Cognitive COVID?
title_sort sars-cov-2 and the brain: what do we know about the causality of ‘cognitive covid?
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8347421/
https://www.ncbi.nlm.nih.gov/pubmed/34362224
http://dx.doi.org/10.3390/jcm10153441
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