Neurological pathogenesis of SARS-CoV-2 (COVID-19): from virological features to clinical symptoms

Abstract

Since the worldwide outbreak of coronavirus disease 2019 (COVID-19) in 2020, various research reports and case reports have been published. It has been found that COVID-19 causes not only respiratory disorders but also thrombosis and gastrointestinal disorders, central nervous system (CNS) disorders, and peripheral neuropathy. Compared to other disorders, there are low number of research reports and low number of summaries on COVID-19-related neural disorders. Therefore, focusing on neural disorders, we outline both basic research and clinical manifestations of COVID-19-related neural disorders.

Keywords: COVID-19; Coronavirus (CoV); Neural disorder; SARS-CoV-2.

Fig. 1

Schematic diagram of the coronavirus structure and genomic structure. a The coronavirus genome is single-stranded RNA, which together with nucleocapsid (N) protein constitutes the nucleocapsid. There is an envelope that encloses the nucleocapsid, which consists of spike (S) protein, integral membrane (M) protein, and envelope (E) protein. b ORF1a and ORF1b continue to exist from the 5' end to approximately 20 kbp. Since the pseudoknot structure exists between the two, two patterns of translation products of the 1a region or 1a + 1b region are generated. Other ORFs encode S protein, E protein, M protein, N protein, etc

Fig. 2

Consideration of the origin of SARS-CoV-2; common sequence of various coronaviruses and SARS-CoV-2. a The RBD within the S1 subunit has a common amino acid sequence between SARS-CoV-2, RATG13, and Pangolin-CoV. The cleavage site has an amino acid sequence (RRAR) unique to SARS-CoV-2. (Modified from Andersen et al. [31])