Impact of COVID-19 on the cerebrovascular system and the prevention of RBC lysis
Impact of COVID-19 on the cerebrovascular system and the prevention of RBC lysis
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DOI：
10.26355/eurrev_202010_23251
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发表时间：
2020-01-01
影响因子：
3.3
通讯作者：
Sindi, A. A-A
中科院分区：
文献类型：
--
作者：
Akhter, N.;Ahmad, S.;Sindi, A. A-A
严重急性呼吸综合征冠状病毒2（SARS-CoV 2）利用血管紧张素转换酶2（ACE 2）受体感染宿主细胞，可能导致冠状病毒疾病（COVID-19）。鉴于脑中存在ACE 2受体以及肾素-血管紧张素系统（RAS）在脑功能中的关键作用，在COVID-19治疗期间需要特别注意脑微循环和神经元炎症。COVID-19患者报告的神经系统并发症包括轻度头晕、头痛、味觉减退、嗅觉减退至严重的脑病、中风、格林-巴利综合征（GBS）、CNS脱髓鞘、这些并发症的病理生理学可能是通过CNS和PNS组织的直接病毒感染或通过包括病毒后自身免疫反应、脓毒症的神经系统后果、高热、缺氧和重症COVID-19患者的高凝状态的间接影响。此外，红细胞（RBC）变形能力降低可能导致COVID-19患者的炎症和缺氧。结合珠蛋白、血红素结合蛋白、血红素氧合酶-1和对乙酰氨基酚可用于维持RBC膜的完整性。
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) uses Angiotensin-converting enzyme 2 (ACE2) receptors to infect host cells which may lead to coronavirus disease (COVID-19). Given the presence of ACE2 receptors in the brain and the critical role of the renin-angiotensin system (RAS) in brain functions, special attention to brain microcirculation and neuronal inflammation is warranted during COVID-19 treatment.Neurological complications reported among COVID-19 patients range from mild dizziness, headache, hypogeusia, hyposmia to severe like encephalopathy, stroke, Guillain-Barre Syndrome (GBS), CNS demyelination, infarcts, microhemorrhages and nerve root enhancement.The pathophysiology of these complications is likely via direct viral infection of the CNS and PNS tissue or through indirect effects including post-viral autoimmune response, neurological consequences of sepsis, hyperpyrexia, hypoxia and hypercoagulability among critically ill COVID-19 patients.Further, decreased deformability of red blood cells (RBC) may be contributing to inflammatory conditions and hypoxia in COVID-19 patients. Haptoglobin, hemopexin, heme oxygenase-1 and acetaminophen may be used to maintain the integrity of the RBC membrane.