Tangled quest of post-COVID-19 infection-caused neuropathology and what 3P nano-bio-medicine can solve?

Nadia M Hamdy; Fatma H Shaker; Xianquan Zhan; Emad B Basalious

doi:10.1007/s13167-022-00285-2

Tangled quest of post-COVID-19 infection-caused neuropathology and what 3P nano-bio-medicine can solve?

EPMA J. 2022 Jun 2;13(2):261-284. doi: 10.1007/s13167-022-00285-2. eCollection 2022 Jun.

Authors

Nadia M Hamdy¹, Fatma H Shaker¹, Xianquan Zhan^{2

3

4}, Emad B Basalious⁵

Affiliations

¹ Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Ain Shams University, Abassia, 11566 Cairo Egypt.
² Shandong Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, 440 Jiyan Road, Jinan, Shandong 250117 People's Republic of China.
³ Medical Science and Technology Innovation Center, Shandong First Medical University, 6699 Qingdao Road, Jinan, Shandong 250117 People's Republic of China.
⁴ Gastroenterology Research Institute and Clinical Center, Shandong First Medical University, 38 Wuying Shan Road, Jinan, Shandong 250031 People's Republic of China.
⁵ Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Al Kasr AlAiny, Cairo, 11562 Egypt.

Abstract

COVID-19-caused neurological problems are the important post-CoV-2 infection complications, which are recorded in ~ 40% of critically ill COVID-19 patients. Neurodegeneration (ND) is one of the most serious complications. It is necessary to understand its molecular mechanism(s), define research gaps to direct research to, hopefully, design new treatment modalities, for predictive diagnosis, patient stratification, targeted prevention, prognostic assessment, and personalized medical services for this type of complication. Individualized nano-bio-medicine combines nano-medicine (NM) with clinical and molecular biomarkers based on omics data to improve during- and post-illness management or post-infection prognosis, in addition to personalized dosage profiling and drug selection for maximum treatment efficacy, safety with least side-effects. This review will enumerate proteins, receptors, and enzymes involved in CoV-2 entrance into the central nervous system (CNS) via the blood-brain barrier (BBB), and list the repercussions after that entry, ranging from neuroinflammation to neurological symptoms disruption mechanism. Moreover, molecular mechanisms that mediate the host effect or viral detrimental effect on the host are discussed here, including autophagy, non-coding RNAs, inflammasome, and other molecular mechanisms of CoV-2 infection neuro-affection that are defined here as hallmarks of neuropathology related to COVID-19 infection. Thus, a couple of questions are raised; for example, "What are the hallmarks of neurodegeneration during COVID-19 infection?" and "Are epigenetics promising solution against post-COVID-19 neurodegeneration?" In addition, nano-formulas might be a better novel treatment for COVID-19 neurological complications, which raises one more question, "What are the challenges of nano-bio-based nanocarriers pre- or post-COVID-19 infection?" especially in the light of omics-based changes/challenges, research, and clinical practice in the framework of predictive preventive personalized medicine (PPPM / 3P medicine).

Keywords: 3P nano-bio-medicine; Autophagy; Biomarker; Blood–brain barrier (BBB); Central nervous system (CNS); Hallmarks of neuropathology; Inflammasome; Multi-omics; Nano-medicine (NM); Nanotechnology; Neurodegeneration; Non-coding RNAs (ncRNA); Patient stratification; Personalized medical service; Post-COVID-19 complications; Post-CoV-2 infection; Predictive diagnosis; Predictive preventive personalized medicine (PPPM / 3P medicine); Prognostic assessment; SARS-CoV2; Targeted prevention.

Publication types

Review