Silent infection — coronavirus attacks the brain perfidiously

Foto: dpa
Doc­tors have been observ­ing symp­toms asso­ci­at­ed with inflam­ma­tion in the brain in Covid 19 patients for a long time. A research group is now get­ting to the bot­tom of this and can deci­pher what Sars-CoV­‑2 does dif­fer­ent­ly than oth­er virus­es. The coro­n­avirus gains access to the human body via the res­pi­ra­to­ry organs, but attacks numer­ous organs there. This also includes the brain. Many sick and con­va­les­cent peo­ple report neu­ro­log­i­cal symp­toms such as olfac­to­ry dis­or­ders, headaches, con­fu­sion, mus­cle pain or severe mus­cle inflam­ma­tion. A con­nec­tion with strokes is also suspected. 

Coro­n­avirus­es in the Covid-19 brain can also trig­ger psychoses

A new study now pro­vides the first clear evi­dence that the coro­n­avirus enters brain cells in some peo­ple. The study by US and British immu­nol­o­gists and neu­rol­o­gists has so far only been pub­lished as an unchecked pre-print. The research group exam­ined whether the Sars-CoV­‑2 can infect the brain and what con­se­quences an infec­tion of the cen­tral ner­vous sys­tem has. To do this, they used brain tis­sue from a per­son who had died of Covid-19, car­ried out ani­mal exper­i­ments on mice and worked with brain cells in the lab­o­ra­to­ry that were sup­posed to mim­ic the three-dimen­sion­al struc­ture of the brain. Oth­er virus­es, such as the Zika virus, are known to attack the brain as well. How­ev­er, accord­ing to the study, the Sars-CoV­‑2 behaves dif­fer­ent­ly. Akiko Iwasa­ki, an immu­nol­o­gist at Yale Uni­ver­si­ty, speaks of a “silent infec­tion” in the New York Times (NYT). The virus uses the brain cells to mul­ti­ply, but does not destroy them. This means that the human organism’s immune response is also absent. The virus appears to soak up all of the oxy­gen near the infect­ed cell and “starve” neigh­bor­ing cells, so to speak.

On secret routes into the brain

It is still unclear how the virus even gets into the brain. Infec­tions of the brain are rather rare, also because it is par­tic­u­lar­ly pro­tect­ed by the blood-brain bar­ri­er. Because the nerve cells can­not be repro­duced. “If the brain becomes infect­ed, it can have fatal con­se­quences,” says Iwasa­ki, who led the study. How­ev­er, it appears that some peo­ple are prone to coro­na infec­tion in the brain due to their genet­ic back­ground, high viral load, or oth­er rea­sons. It has long been sus­pect­ed that Sars-CoV­‑2, start­ing from the mucous mem­branes of the upper res­pi­ra­to­ry tract, attacks the olfac­to­ry nerve and from there reach­es the brain. Pen­e­tra­tion through the eyes or the blood­stream also appears pos­si­ble. Alysson Muotri, a neu­ro­sci­en­tist at the Uni­ver­si­ty of Cal­i­for­nia at San Diego, who has also done research on the Zika virus, sus­pects that the coro­n­avirus reduces the num­ber of synaps­es, the con­nec­tions between neu­rons. This effect is already vis­i­ble days after the infec­tion, Muotri told the NYT. The researchers assume that it is once again the ACE2 recep­tor that Sars-CoV­‑2 serves as the por­tal of entry into the body. Although there is very lit­tle ACE2 in the brain, the virus has been shown to use this pro­tein in oth­er organs to penetrate.

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In addi­tion, the sci­en­tists were able to show that a neu­ronal infec­tion can be pre­vent­ed: Either by block­ing ACE2 with anti­bod­ies or by admin­is­ter­ing cere­brospinal flu­id from a Covid-19 patient. Through the exper­i­ments with mice, the researchers come to the con­clu­sion that a viral infec­tion in the brain can be more dead­ly than an infec­tion of the res­pi­ra­to­ry tract. If the mice had the infec­tion in the brain, they died with­in six days; if the lung was infect­ed, this was not the case. Doc­tors had repeat­ed­ly report­ed that severe ill­ness­es result­ed in increased lev­els of impaired con­scious­ness, delir­i­um or strokes. They are now con­sid­ered an indi­ca­tor of a poor­er prog­no­sis for Covid 19 patients.



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