Nervous system-related tropism of SARS-CoV-2 and autoimmunity in COVID-19 infection

Eur J Immunol. 2024 Jan;54(1):e2250230. doi: 10.1002/eji.202250230. Epub 2023 Sep 27.

Abstract

The effects of SARS-CoV-2 in COVID-19 on the nervous system are incompletely understood. SARS-CoV-2 can infect endothelial cells, neurons, astrocytes, and oligodendrocytes with consequences for the host. There are indications that infection of these CNS-resident cells may result in long-term effects, including emergence of neurodegenerative diseases. Indirect effects of infection with SARS-CoV-2 relate to the induction of autoimmune disease involving molecular mimicry or/and bystander activation of T- and B cells and emergence of autoantibodies against various self-antigens. Data obtained in preclinical models of coronavirus-induced disease gives important clues for the understanding of nervous system-related assault of SARS-CoV-2. The pathophysiology of long-COVID syndrome and post-COVID syndrome in which autoimmunity and immune dysregulation might be the driving forces are still incompletely understood. A better understanding of nervous-system-related immunity in COVID-19 might support the development of therapeutic approaches. In this review, the current understanding of SARS-CoV-2 tropism for the nervous system, the associated immune responses, and diseases are summarized. The data indicates that there is viral tropism of SARS-CoV-2 in the nervous system resulting in various disease conditions. Prevention of SARS-CoV-2 infection by means of vaccination is currently the best strategy for the prevention of subsequent tissue damage involving the nervous system.

Keywords: COVID-19; Lymphocyte; Nervous system; Post-COVID; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Autoimmunity
  • COVID-19*
  • Endothelial Cells
  • Humans
  • Nervous System
  • Post-Acute COVID-19 Syndrome
  • SARS-CoV-2
  • Tropism