Cytokine storm induced by SARS-CoV-2 infection: The spectrum of its neurological manifestations

• Published in: Cytokine (Philadelphia, Pa.) Pa.), 2021-02, Vol.138, p.155404-155404, Article 155404
• Main Authors: Thepmankorn, Parisorn, Bach, John, Lasfar, Ahmed, Zhao, Xilin, Souayah, Sami, Chong, Zhao Zhong, Souayah, Nizar
• Format: Article
• Language: English
• Subjects: Central Nervous System - pathology; Cerebrovascular disease; Cerebrovascular Disorders - pathology; Cerebrovascular Disorders - virology; Coronavirus; COVID-19; COVID-19 - pathology; COVID-19 - therapy; Cytokine Release Syndrome - pathology; Cytokine Release Syndrome - therapy; Cytokine storm; Cytokines - blood; Encephalopathy; Guillain-Barré Syndrome; Humans; Hypercytokinemia; Interferons; Nervous System Diseases - pathology; Nervous System Diseases - virology; Neurological complications; Peripheral Nervous System - pathology; Review; SARS-CoV-2; Skeletal muscle injury
• ISSN: 1043-4666; 1096-0023; 1096-0023
• DOI: 10.1016/j.cyto.2020.155404

•COVID-19 can have CNS and PNS neurological manifestations.•Headache and hyposmia are common neurological symptoms.•COVID-19 could trigger cytokine storm.•COVID-19 neurological sequalae may be due to viral neuroinvasion and cytokine storm.•Cytokine storm-targeting therapies may help manage COVID-19 neurological symptoms. The new coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can trigger a hyperinflammatory state characterized by elevated cytokine levels known as hypercytokinemia or cytokine storm, observed most often in severe patients. Though COVID-19 is known to be a primarily respiratory disease, neurological complications affecting both the central and peripheral nervous systems have also been reported. This review discusses potential routes of SARS-CoV-2 neuroinvasion and pathogenesis, summarizes reported neurological sequelae of COVID-19, and examines how aberrant cytokine levels may precipitate these complications. Clarification of the pathogenic mechanisms of SARS-CoV-2 is needed to encourage prompt diagnosis and optimized care. In particular, identifying the presence of cytokine storm in patients with neurological COVID-19 manifestations will facilitate avenues for treatment. Future investigations into aberrant cytokine levels in COVID-19 patients with neurological symptoms as well as the efficacy of cytokine storm-targeting treatments will be critical in elucidating the pathogenic mechanisms and effective treatments of COVID-19.