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. 2023 Jan 16;13(1):e134129.
doi: 10.5812/aapm-134129. eCollection 2023 Feb.

SARS‑CoV‑2 and Seizure: An Insight Into the Pathophysiology

Seyed Amir Abbas Ahadiat  1 , Zeinab Hosseinian  2
Affiliations

SARS‑CoV‑2 and Seizure: An Insight Into the Pathophysiology

Seyed Amir Abbas Ahadiat et al. Anesth Pain Med. .
No abstract available

Keywords: COVID-19; Cytokine; Neurology; SARS-CoV-2; Seizures.

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Conflict of interest statement

Conflict of Interests: There are no conflicts of interest.

Figures

Figure 1.
Figure 1.. Mechanisms of Sars-COV-2 invasion of the CNS. Hematogenous route: A. A transcellular migration occurs when the virus binds to its receptors, ACE2, or neuropilin-1 (NRP-1), on brain microvasculature endothelial cells and crosses the endothelial cell via transcytosis. SARS-COV-2 depletes the ACE2 receptor by infecting target cells, including endothelial cells, resulting in the accumulation of angiotensin II (ANGII). A high level of ANGII can cause vasoconstriction, fluid retention, inflammation, and blood coagulation, resulting in an ischemic or hemorrhagic stroke. B. Infection immune cells, which then carry the virus across the blood-brain barrier (BBB) endothelial cells into the CNS (Trojan Horse mechanism). Transsynaptic route: C. The SARS-COV-2 infects the olfactory epithelium ,reaches the CNS through the olfactory neurons, and causes encephalitis. Other mechanisms: D. Role of HIF-1α in hypoxia signaling in covid-19. Infection with SARS-COV-2 causes severe inflammation, acute respiratory distress syndrome (ARDS), and hypoxia in the lungs. As a result, hypoxia and inflammation induced encephalopathy and seizure occur. When Sars-cov-2 entering host cells, viral ORF3a protein induces HIF-1α expression through triggering mitochondrial reactive oxygen species (ROS) activation. The accumulated HIF-1α leads to a cytokine storm. This figure was created by Seyed Amir Abbas Ahadia with Biorender.com.
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