Human coronaviruses are highly pathogenic viruses that pose a serious threat to human health. Examples include the severe acute respiratory syndrome outbreak of 2003 (SARS-CoV-1), the Middle East Respiratory Syndrome (MERS-CoV) outbreak of 2012, and the current SARS-CoV-2 (COVID-19) pandemic. Herein, we review the neurological manifestations of coronaviruses and discuss the potential pathogenic role of blood–brain barrier dysfunction. We present the hypothesis that pre-existing vascular damage (due to aging, cardiovascular disease, diabetes, hypertension or other conditions) facilitates infiltration of the virus into the central nervous system (CNS), increasing neuro-inflammation and the likelihood of neurological symptoms. We also discuss the role of a neuroinflammatory cytokine profile in both blood–brain barrier dysfunction and macrovascular disease (e.g. ischemic stroke and thromboembolism). Future studies are needed to better understand the involvement of the microvasculature in coronavirus neuropathology, and to test the diagnostic potential of minimally-invasive screening tools (e.g. serum biomarkers, fluorescein retinal angiography and dynamic-contrast MRI).
【저자키워드】 SARS-CoV-2, coronavirus, stroke, NEUROLOGY, blood–brain barrier, neurological, 【초록키워드】 COVID-19, pandemic, Human, diagnostic, cardiovascular disease, diabetes, virus, hypertension, SARS-CoV-1, MERS-CoV, MRI, Fluorescein, Health, outbreak, Thromboembolism, Central nervous system, Neurological symptoms, respiratory, serum biomarkers, disease, CNS, cytokine profile, infiltration, Hypothesis, Vascular damage, Middle East, dysfunction, acute respiratory syndrome, pathogenic, highly pathogenic, Future, neurological manifestation, likelihood, virus, include, facilitate, coronavirus, conditions, 【제목키워드】 pathology, Coronavirus infection, neurological manifestation,