Autonomic Brain Centers and Pathophysiology of COVID-19

ACS Chem Neurosci. 2020 Jun 3;11(11):1520-1522. doi: 10.1021/acschemneuro.0c00265. Epub 2020 May 19.

Abstract

Accumulating data have now shown strong evidence that COVID-19 infection leads to the occurrence of neurological signs with different injury severity. Anosmia and agueusia are now well documented and included in the criteria list for diagnosis, and specialists have stressed that doctors screen COVID-19 patients for these two signs. The eventual brainstem dysregulation, due to the invasion of SARS CoV-2, as a cause of respiratory problems linked to COVID-19, has also been extensively discussed. All these findings lead to an implication of the central nervous system in the pathophysiology of COVID-19. Here we provide additional elements that could explain other described signs like appetite loss, vomiting, and nausea. For this, we investigated the role of brainstem structures located in the medulla oblongata involved in food intake and vomiting control. We also discussed the possible pathways the virus uses to reach the brainstem, i.e., neurotropic and hematogenous (with its two variants) routes.

Keywords: COVID-19; Coronavirus; central nervous system; food intake control; nausea and vomiting.

MeSH terms

  • Ageusia / etiology
  • Anorexia / etiology
  • Anorexia / physiopathology*
  • Appetite Regulation / physiology*
  • Area Postrema / physiopathology
  • Autonomic Nervous System / physiopathology*
  • Blood-Brain Barrier
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / physiopathology*
  • Eating / physiology*
  • Humans
  • Hypothalamus / physiopathology
  • Medulla Oblongata / physiopathology
  • Nausea / etiology
  • Nausea / physiopathology*
  • Neural Pathways / physiopathology
  • Olfaction Disorders / etiology
  • Olfactory Nerve
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / physiopathology*
  • Solitary Nucleus / physiopathology*
  • Vagus Nerve
  • Vomiting / etiology
  • Vomiting / physiopathology*