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Nat Neurosci . Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19

tetano

Editor, Senior Moderator
Nat Neurosci


. 2020 Nov 30.
doi: 10.1038/s41593-020-00758-5. Online ahead of print.
Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19


Jenny Meinhardt[SUP] 1 [/SUP], Josefine Radke[SUP] 1 2 3 [/SUP], Carsten Dittmayer[SUP] 1 [/SUP], Jonas Franz[SUP] 4 5 6 [/SUP], Carolina Thomas[SUP] 4 6 [/SUP], Ronja Mothes[SUP] 1 [/SUP], Michael Laue[SUP] 7 [/SUP], Julia Schneider[SUP] 8 [/SUP], Sebastian Br?nink[SUP] 8 [/SUP], Selina Greuel[SUP] 9 [/SUP], Malte Lehmann[SUP] 10 [/SUP], Olga Hassan[SUP] 1 [/SUP], Tom Aschman[SUP] 1 [/SUP], Elisa Schumann[SUP] 1 3 [/SUP], Robert Lorenz Chua[SUP] 11 [/SUP], Christian Conrad[SUP] 11 [/SUP], Roland Eils[SUP] 11 12 [/SUP], Werner Stenzel[SUP] 1 [/SUP], Marc Windgassen[SUP] 13 [/SUP], Larissa R??ler[SUP] 13 [/SUP], Hans-Hilmar Goebel[SUP] 1 [/SUP], Hans R Gelderblom[SUP] 7 [/SUP], Hubert Martin[SUP] 1 [/SUP], Andreas Nitsche[SUP] 7 [/SUP], Walter J Schulz-Schaeffer[SUP] 14 [/SUP], Samy Hakroush[SUP] 15 [/SUP], Martin S Winkler[SUP] 16 [/SUP], Bj?rn Tampe[SUP] 17 [/SUP], Franziska Scheibe[SUP] 18 19 [/SUP], P?ter K?rtv?lyessy[SUP] 18 20 [/SUP], Dirk Reinhold[SUP] 21 [/SUP], Britta Siegmund[SUP] 10 [/SUP], Anja A K?hl[SUP] 22 [/SUP], Sefer Elezkurtaj[SUP] 9 [/SUP], David Horst[SUP] 9 [/SUP], Lars Oesterhelweg[SUP] 13 [/SUP], Michael Tsokos[SUP] 13 [/SUP], Barbara Ingold-Heppner[SUP] 23 [/SUP], Christine Stadelmann[SUP] 4 [/SUP], Christian Drosten[SUP] 8 [/SUP], Victor Max Corman[SUP] 8 [/SUP], Helena Radbruch[SUP] 1 [/SUP], Frank L Heppner[SUP] 24 25 26 27 [/SUP]



Affiliations

Abstract

The newly identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, a pandemic respiratory disease. Moreover, thromboembolic events throughout the body, including in the CNS, have been described. Given the neurological symptoms observed in a large majority of individuals with COVID-19, SARS-CoV-2 penetrance of the CNS is likely. By various means, we demonstrate the presence of SARS-CoV-2 RNA and protein in anatomically distinct regions of the nasopharynx and brain. Furthermore, we describe the morphological changes associated with infection such as thromboembolic ischemic infarction of the CNS and present evidence of SARS-CoV-2 neurotropism. SARS-CoV-2 can enter the nervous system by crossing the neural-mucosal interface in olfactory mucosa, exploiting the close vicinity of olfactory mucosal, endothelial and nervous tissue, including delicate olfactory and sensory nerve endings. Subsequently, SARS-CoV-2 appears to follow neuroanatomical structures, penetrating defined neuroanatomical areas including the primary respiratory and cardiovascular control center in the medulla oblongata.
 
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