The Potential Role of COVID-19 in the Pathogenesis of Multiple Sclerosis-A Preliminary Report

Viruses. 2021 Oct 17;13(10):2091. doi: 10.3390/v13102091.

Abstract

Coronavirus 2019 (COVID-19) is an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that mainly affects the lungs. COVID-19 symptoms include the presence of fevers, dry coughs, fatigue, sore throat, headaches, diarrhea, and a loss of taste or smell. However, it is understood that SARS-CoV-2 is neurotoxic and neuro-invasive and could enter the central nervous system (CNS) via the hematogenous route or via the peripheral nerve route and causes encephalitis, encephalopathy, and acute disseminated encephalomyelitis (ADEM) in COVID-19 patients. This review discusses the possibility of SARS-CoV-2-mediated Multiple Sclerosis (MS) development in the future, comparable to the surge in Parkinson's disease cases following the Spanish Flu in 1918. Moreover, the SARS-CoV-2 infection is associated with a cytokine storm. This review highlights the impact of these modulated cytokines on glial cell interactions within the CNS and their role in potentially prompting MS development as a secondary disease by SARS-CoV-2. SARS-CoV-2 is neurotropic and could interfere with various functions of neurons leading to MS development. The influence of neuroinflammation, microglia phagocytotic capabilities, as well as hypoxia-mediated mitochondrial dysfunction and neurodegeneration, are mechanisms that may ultimately trigger MS development.

Keywords: COVID-19; SARS-CoV-2; coronavirus; multiple sclerosis; neuroinflammation.

Publication types

  • Historical Article
  • Review

MeSH terms

  • COVID-19 / complications*
  • COVID-19 / pathology*
  • Central Nervous System / pathology*
  • Central Nervous System / virology
  • Cytokine Release Syndrome / pathology
  • Cytokines / blood
  • Cytokines / metabolism
  • History, 20th Century
  • Humans
  • Influenza Pandemic, 1918-1919 / statistics & numerical data
  • Multiple Sclerosis / pathology*
  • Multiple Sclerosis / virology
  • Neurodegenerative Diseases / pathology
  • Neurodegenerative Diseases / virology*
  • Post-Acute COVID-19 Syndrome
  • SARS-CoV-2 / immunology

Substances

  • Cytokines