Abstract
The new coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can present neurological symptoms and induce neurological complications. The involvement in both the central and peripheral nervous systems in COVID-19 patients has been associated with direct invasion of the virus and the induction of cytokine storm. This review discussed the pathways for the virus invasion into the nervous system and characterized the SARS-CoV-2 induced cytokine storm. In addition, the mechanisms underlying the immune responses and cytokine storm induction after SARS-CoV-2 infection were also discussed. Although some neurological symptoms are mild and disappear after recovery from infection, some severe neurological complications contribute to the mortality of COVID-19 patients. Therefore, the insight into the cause of SARS-CoV-2 induced cytokine storm in context with neurological complications will formulate the novel management of the disease and also further identify new therapeutic targets for COVID-19.
Keywords: Cytokine, COVID-19, neurological complications, Toll-like receptors, interferon, Janus kinase.
[http://dx.doi.org/10.1080/22221751.2020.1719902] [PMID: 31987001]
[http://dx.doi.org/10.1503/cmaj.200869] [PMID: 32461325]
[http://dx.doi.org/10.1056/NEJMc2008597] [PMID: 32294339]
[http://dx.doi.org/10.1001/jamaneurol.2020.1127] [PMID: 32275288]
[http://dx.doi.org/10.1016/S0140-6736(20)30211-7] [PMID: 32007143]
[http://dx.doi.org/10.1016/S0140-6736(20)30183-5] [PMID: 31986264]
[http://dx.doi.org/10.1007/s00405-020-05965-1] [PMID: 32253535]
[http://dx.doi.org/10.1093/cid/ciaa330] [PMID: 32215618]
[http://dx.doi.org/10.1212/WNL.0000000000009863] [PMID: 32439822]
[http://dx.doi.org/10.1016/j.jdcr.2020.05.012] [PMID: 32572380]
[http://dx.doi.org/10.1007/s10072-020-04449-8] [PMID: 32399950]
[http://dx.doi.org/10.1016/j.neurol.2020.04.003] [PMID: 32334841]
[http://dx.doi.org/10.7861/clinmed.2020-0213] [PMID: 32518103]
[http://dx.doi.org/10.1136/bcr-2020-236182] [PMID: 32540883]
[http://dx.doi.org/10.1056/NEJMc2009191] [PMID: 32302082]
[http://dx.doi.org/10.1212/WNL.0000000000009700] [PMID: 32358218]
[http://dx.doi.org/10.1212/WNL.0000000000009619] [PMID: 32303650]
[http://dx.doi.org/10.1016/j.jns.2020.116888] [PMID: 32413767]
[http://dx.doi.org/10.3201/eid2607.200445] [PMID: 32197060]
[http://dx.doi.org/10.1016/j.ijid.2020.03.062] [PMID: 32251791]
[http://dx.doi.org/10.1002/epi4.12399] [PMID: 32537529]
[http://dx.doi.org/10.1016/j.seizure.2020.04.009] [PMID: 32344366]
[http://dx.doi.org/10.1056/NEJMc2009787] [PMID: 32343504]
[http://dx.doi.org/10.1016/j.thromres.2020.04.041] [PMID: 32381264]
[http://dx.doi.org/10.1016/j.nmni.2020.100669] [PMID: 32322398]
[http://dx.doi.org/10.1016/j.bbi.2020.05.022] [PMID: 32389697]
[http://dx.doi.org/10.1007/s10140-020-01837-7] [PMID: 32778985]
[http://dx.doi.org/10.1007/s00701-020-04402-w] [PMID: 32430637]
[http://dx.doi.org/10.1016/j.bbi.2020.04.024] [PMID: 32305574]
[http://dx.doi.org/10.1016/j.pediatrneurol.2020.04.013] [PMID: 32586676]
[http://dx.doi.org/10.1002/ana.25783] [PMID: 32418288]
[http://dx.doi.org/10.1016/j.jinf.2020.03.037] [PMID: 32283152]
[http://dx.doi.org/10.1097/PRA.0000000000000527] [PMID: 33656822]
[http://dx.doi.org/10.1097/PRA.0000000000000533] [PMID: 33656820]
[http://dx.doi.org/10.1016/S2215-0366(20)30203-0] [PMID: 32437679]
[http://dx.doi.org/10.1080/13550280590922793] [PMID: 16036791]
[http://dx.doi.org/10.1002/jmv.26105] [PMID: 32492193]
[http://dx.doi.org/10.1128/JVI.79.6.3846-3850.2005] [PMID: 15731278]
[http://dx.doi.org/10.1016/S0014-5793(02)03640-2] [PMID: 12459472]
[http://dx.doi.org/10.1093/cvr/cvaa078] [PMID: 32227090]
[http://dx.doi.org/10.1002/path.1670] [PMID: 15538735]
[http://dx.doi.org/10.1538/expanim.17-0053] [PMID: 28845018]
[http://dx.doi.org/10.1002/path.1570] [PMID: 15141377]
[http://dx.doi.org/10.1126/sciadv.abc5801] [PMID: 32937591]
[http://dx.doi.org/10.1124/molpharm.120.000014] [PMID: 32238438]
[http://dx.doi.org/10.1007/s11064-018-2679-4] [PMID: 30443713]
[http://dx.doi.org/10.1016/j.neuropharm.2014.01.004] [PMID: 24440367]
[http://dx.doi.org/10.1016/j.bbrc.2020.09.042] [PMID: 33008593]
[http://dx.doi.org/10.1016/j.jep.2019.112470] [PMID: 31862407]
[http://dx.doi.org/10.1212/WNL.0000000000009455] [PMID: 32229625]
[http://dx.doi.org/10.1128/JVI.78.7.3398-3406.2004] [PMID: 15016862]
[http://dx.doi.org/10.1002/jmv.25728] [PMID: 32104915]
[http://dx.doi.org/10.1016/j.nbd.2020.105131] [PMID: 33053430]
[http://dx.doi.org/10.1016/j.chom.2013.03.010] [PMID: 23601101]
[http://dx.doi.org/10.1016/j.bbi.2020.03.031] [PMID: 32240762]
[http://dx.doi.org/10.1093/cid/ciaa248] [PMID: 32161940]
[http://dx.doi.org/10.3389/fimmu.2020.01708] [PMID: 32754163]
[http://dx.doi.org/10.1111/bjh.16659] [PMID: 32297671]
[http://dx.doi.org/10.1002/ajh.25822] [PMID: 32267008]
[http://dx.doi.org/10.1046/j.1365-2362.1997.570614.x] [PMID: 9041370]
[http://dx.doi.org/10.1128/MCB.8.12.5588] [PMID: 2854203]
[http://dx.doi.org/10.1055/s-0038-1650653] [PMID: 8950783]
[http://dx.doi.org/10.1002/ajh.25962] [PMID: 32780525]
[http://dx.doi.org/10.1007/s10238-020-00662-z] [PMID: 32949308]
[http://dx.doi.org/10.1016/S0140-6736(20)30566-3] [PMID: 32171076]
[http://dx.doi.org/10.1111/jth.14988] [PMID: 32619329]
[http://dx.doi.org/10.3389/fimmu.2020.01625] [PMID: 32719685]
[http://dx.doi.org/10.1111/j.1365-2249.2004.02415.x] [PMID: 15030519]
[http://dx.doi.org/10.1172/JCI137244] [PMID: 32217835]
[http://dx.doi.org/10.1038/s41588-020-00732-8] [PMID: 33077915]
[http://dx.doi.org/10.1056/NEJMc2008597]
[http://dx.doi.org/10.1126/science.abc6027] [PMID: 32661059]
[http://dx.doi.org/10.1038/s41392-020-00306-4] [PMID: 32929061]
[http://dx.doi.org/10.1038/s41467-020-17665-9] [PMID: 32733001]
[http://dx.doi.org/10.1080/22221751.2020.1780953] [PMID: 32529952]
[PMID: 33140044]
[http://dx.doi.org/10.1523/JNEUROSCI.21-04-01179.2001] [PMID: 11160388]
[http://dx.doi.org/10.2174/1567202054368317] [PMID: 16181114]
[http://dx.doi.org/10.1016/j.pneurobio.2005.02.004] [PMID: 15882775]
[http://dx.doi.org/10.1016/j.yexmp.2020.104474] [PMID: 32454103]
[http://dx.doi.org/10.1016/j.coviro.2014.12.009] [PMID: 25681709]
[http://dx.doi.org/10.1007/978-3-319-60189-2_8] [PMID: 28889267]
[http://dx.doi.org/10.2174/156720212803530618] [PMID: 22873724]
[http://dx.doi.org/10.1016/j.redox.2019.101295] [PMID: 31421410]
[http://dx.doi.org/10.1155/2013/510396] [PMID: 23864878]
[http://dx.doi.org/10.3389/fimmu.2014.00461] [PMID: 25309543]
[http://dx.doi.org/10.1124/pr.114.010090] [PMID: 26721702]
[http://dx.doi.org/10.1038/90609] [PMID: 11477402]
[http://dx.doi.org/10.1016/j.cyto.2018.04.008] [PMID: 29656958]
[http://dx.doi.org/10.1016/j.imbio.2014.07.016] [PMID: 25108563]
[http://dx.doi.org/10.3346/jkms.2020.35.e343] [PMID: 32989935]
[http://dx.doi.org/10.1152/physrev.00023.2016] [PMID: 29351514]
[http://dx.doi.org/10.1161/HYPERTENSIONAHA.118.10266] [PMID: 29581215]
[http://dx.doi.org/10.1172/JCI7451] [PMID: 10606623]
[http://dx.doi.org/10.1159/000218173] [PMID: 19471094]
[http://dx.doi.org/10.1007/s00011-009-0012-z] [PMID: 19271152]
[http://dx.doi.org/10.1210/en.2011-1326] [PMID: 21862613]
[http://dx.doi.org/10.1016/j.tibs.2016.09.002] [PMID: 27669650]
[http://dx.doi.org/10.1016/j.redox.2015.01.008] [PMID: 25625584]
[PMID: 33066442]
[PMID: 33188780]
[http://dx.doi.org/10.1016/j.bbi.2020.09.017] [PMID: 32971182]
[http://dx.doi.org/10.3389/fimmu.2020.01580] [PMID: 32670297]
[http://dx.doi.org/10.1155/2020/8829674] [PMID: 33343232]
[http://dx.doi.org/10.1021/acschemneuro.0c00210] [PMID: 32379417]
[http://dx.doi.org/10.1021/acschemneuro.0c00596] [PMID: 32997488]
[http://dx.doi.org/10.1038/s41593-020-00758-5] [PMID: 33257876]
[http://dx.doi.org/10.1021/acschemneuro.0c00249] [PMID: 32525657]
[http://dx.doi.org/10.3390/nu11092251] [PMID: 31546789]
[http://dx.doi.org/10.1038/s41368-020-0074-x] [PMID: 32094336]
[http://dx.doi.org/10.1007/s00405-020-06054-z] [PMID: 32435852]
[http://dx.doi.org/10.1111/j.1749-6632.2009.04480.x] [PMID: 19686199]
[http://dx.doi.org/10.1007/s00405-020-06154-w] [PMID: 32577904]
[http://dx.doi.org/10.1016/j.jfma.2020.04.024] [PMID: 32354690]
[PMID: 33214969]
[http://dx.doi.org/10.1007/s13365-020-00912-6] [PMID: 33006717]
[http://dx.doi.org/10.1007/s00415-019-09282-4] [PMID: 30923934]
[http://dx.doi.org/10.1590/0004-282x20200127] [PMID: 33111851]
[http://dx.doi.org/10.1097/CND.0000000000000316] [PMID: 32833728]
[http://dx.doi.org/10.1016/S1474-4422(20)30109-5] [PMID: 32246917]
[http://dx.doi.org/10.1111/ene.14383] [PMID: 32503084]
[http://dx.doi.org/10.1016/j.msard.2020.102324] [PMID: 32615528]
[http://dx.doi.org/10.1016/j.jocn.2020.04.062] [PMID: 32312628]
[http://dx.doi.org/10.1007/s12192-020-01145-6] [PMID: 32729001]
[http://dx.doi.org/10.1016/j.msard.2020.102377] [PMID: 32698095]
[http://dx.doi.org/10.1016/j.ensci.2020.100299] [PMID: 33313429]
[http://dx.doi.org/10.1007/s00415-020-09996-w] [PMID: 32564153]
[http://dx.doi.org/10.1016/S0140-6736(20)30628-0] [PMID: 32192578]
[http://dx.doi.org/10.1007/s00701-020-04374-x] [PMID: 32367205]
[http://dx.doi.org/10.1007/s12035-020-02094-y] [PMID: 32869183]
[http://dx.doi.org/10.1002/jmv.26309] [PMID: 32672843]
[http://dx.doi.org/10.1007/s00415-020-10108-x] [PMID: 32734353]
[http://dx.doi.org/10.1016/j.nrleng.2020.05.008] [PMID: 32448674]
[http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.105231] [PMID: 33066910]
[PMID: 32467443]
[http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2020.104984] [PMID: 32689588]
[http://dx.doi.org/10.18632/aging.103335] [PMID: 32527987]
[http://dx.doi.org/10.1038/s41440-020-0488-z] [PMID: 32523133]
[http://dx.doi.org/10.1016/j.rcp.2020.10.009] [PMID: 33648695]
[http://dx.doi.org/10.1136/bcr-2020-240088] [PMID: 33328211]
[PMID: 33581959]
[http://dx.doi.org/10.3390/cells9112360] [PMID: 33120941]
[http://dx.doi.org/10.1002/14651858.CD004882.pub2] [PMID: 16437501]
[http://dx.doi.org/10.2169/internalmedicine.5630-20] [PMID: 33087668]
[http://dx.doi.org/10.12659/AJCR.924476] [PMID: 32796809]
[http://dx.doi.org/10.1016/j.chest.2020.09.275] [PMID: 33075378]
[http://dx.doi.org/10.1093/cid/ciz544] [PMID: 31925415]
[http://dx.doi.org/10.1164/rccm.201706-1172OC] [PMID: 29161116]
[http://dx.doi.org/10.1038/s41467-018-04574-1] [PMID: 29884817]
[http://dx.doi.org/10.1016/j.cmi.2020.09.014] [PMID: 32971254]
[http://dx.doi.org/10.1172/JCI140617] [PMID: 33141117]
[http://dx.doi.org/10.1016/S1473-3099(20)30232-2] [PMID: 32199493]
[http://dx.doi.org/10.1016/j.jinf.2020.05.023] [PMID: 32417314]
[http://dx.doi.org/10.1016/j.antiviral.2020.104811] [PMID: 32360182]
[PMID: 32511335]
[http://dx.doi.org/10.1016/j.intimp.2020.106688] [PMID: 32544867]
[http://dx.doi.org/10.1186/s13054-020-03048-5] [PMID: 32532353]
[http://dx.doi.org/10.1038/s41467-019-13940-6] [PMID: 31924756]
[http://dx.doi.org/10.3389/fimmu.2020.01061] [PMID: 32574262]
[http://dx.doi.org/10.1016/j.micinf.2020.05.012] [PMID: 32445881]
[http://dx.doi.org/10.1016/S2213-2600(20)30511-7] [PMID: 33189161]
[http://dx.doi.org/10.1016/j.ijid.2020.11.008] [PMID: 33181328]
[http://dx.doi.org/10.1084/jem.20200653] [PMID: 32289152]
[http://dx.doi.org/10.1038/s41590-019-0345-x] [PMID: 30886417]
[http://dx.doi.org/10.1371/journal.ppat.1000017] [PMID: 18369468]
[http://dx.doi.org/10.1016/j.mehy.2020.110351] [PMID: 33129578]
[http://dx.doi.org/10.1021/acs.jproteome.0c00365] [PMID: 32786691]
[http://dx.doi.org/10.1172/JCI30639] [PMID: 17885684]
[http://dx.doi.org/10.1186/s12967-020-02571-x] [PMID: 33121497]
[http://dx.doi.org/10.5005/jp-journals-10071-23566] [PMID: 33132558]
[http://dx.doi.org/10.3389/fmed.2020.586221] [PMID: 33123544]
[http://dx.doi.org/10.1136/annrheumdis-2020-219265] [PMID: 33127662]
[PMID: 32573419]
[http://dx.doi.org/10.1016/j.autrev.2020.102568] [PMID: 32376398]
[http://dx.doi.org/10.1182/blood-2008-05-155846] [PMID: 18784373]
[http://dx.doi.org/10.1182/blood-2010-07-273417] [PMID: 21304099]
[http://dx.doi.org/10.1016/S2665-9913(20)30167-3] [PMID: 32835251]
[http://dx.doi.org/10.1002/clc.23451] [PMID: 32830894]
[http://dx.doi.org/10.1016/S2665-9913(20)30127-2] [PMID: 32501454]
[http://dx.doi.org/10.1136/annrheumdis-2020-217706] [PMID: 32376597]
[http://dx.doi.org/10.1016/S2665-9913(20)30164-8] [PMID: 32835245]
[http://dx.doi.org/10.1073/pnas.2009017117] [PMID: 32699149]
[http://dx.doi.org/10.1016/j.cjco.2020.10.003] [PMID: 33073222]
[http://dx.doi.org/10.1016/j.chom.2020.05.007]
[http://dx.doi.org/10.1016/j.jbspin.2019.09.005] [PMID: 31521793]
[http://dx.doi.org/10.1016/j.autrev.2019.102390] [PMID: 31520803]
[http://dx.doi.org/10.1159/000508247] [PMID: 32392562]
[http://dx.doi.org/10.1126/sciadv.abe4724] [PMID: 33187978]
[http://dx.doi.org/10.1007/s00415-020-09866-5] [PMID: 32361836]
[http://dx.doi.org/10.1159/000510770] [PMID: 32818929]
[http://dx.doi.org/10.3389/fmed.2020.00466] [PMID: 32850921]
[PMID: 9317152]
[http://dx.doi.org/10.1016/j.ijcard.2019.06.070] [PMID: 31522718]
[http://dx.doi.org/10.1016/j.mehy.2016.04.039] [PMID: 27241260]
[http://dx.doi.org/10.1093/ehjcvp/pvaa033] [PMID: 32337546]
[http://dx.doi.org/10.1111/ajt.15891] [PMID: 32233067]
[http://dx.doi.org/10.1016/j.bbadis.2016.11.005] [PMID: 27825853]
[http://dx.doi.org/10.1038/ncomms11624] [PMID: 27211851]
[http://dx.doi.org/10.1134/S0006297920070111] [PMID: 33040727]
[http://dx.doi.org/10.1038/s41467-020-18764-3] [PMID: 33009401]