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Year : 2020  |  Volume : 68  |  Issue : 5  |  Page : 989--993

Brainstem Dysfunction in SARS-COV-2 Infection can be a Potential Cause of Respiratory Distress


1 Institute of Neurology and Neurosurgery, Department of Clinical Neurophysiology, Havana, Cuba
2 International Brain Research Foundation, Inc. Chief Executive Officer, 227 Rte. 206, Flanders, New Jersey, United States

Correspondence Address:
Dr. Calixto Machado
Institute of Neurology and Neurosurgery Department of Clinical Neurophysiology 29 y D, Vedado, La Habana 10400
Cuba
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.299165

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Background: A terrible pandemic, Covid-19, has captivated scientists to investigate if SARS-CoV-2 virus infects the central nervous system (CNS). A crucial question is if acute respiratory distress syndrome (ARDS), the main cause of death in this pandemic, and often refractory to treatments, can be explained by respiratory center dysfunction. Objective: To discuss that ARDS can be caused by SARS-CoV-2 infection of the respiratory center in the brainstem. Materials and Methods: I reviewed literature about SARS-CoV-2 mechanisms to infect the respiratory center in the brainstem. Results and Conclusions: An increasing amount of reports demonstrates that neurotropism is a common feature of coronavirus, which have been found in the brains of patients and experimental models, where the brainstem was severely infested. Recent studies have provided tremendous indication of the incidence of acute respiratory failure due to SARS-CoV-2 infection of the brainstem. SARS-CoV-2 might infect the CNS through the olfactory bulb, spreading from the olfactory nerves to the rhinencephalon, and finally reaching the brainstem. Hence, the virus infection causes respiratory center dysfunctions, leading to ARDS in COVID-19 patients. I conclude that acute ARDS in Covid-19 can be caused by SARS-CoV-2 invasion of brainstem respiratory center, suggesting the needs of more specific and aggressive treatments, with the direct participation of neurologists and neurointensivists.






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