Neurologic Alterations Due to Respiratory Virus Infections

Bohmwald, Karen; Gálvez, Nicolás M. S.; Ríos, Mariana; Kalergis, Alexis M.

The first case of SARS-CoV infection with neurological manifestations was reported the year 2003 in a 59-year-old woman (Hung et al., 2003) . She was first admitted with swinging fever, chills, productive coughing and diarrhea, which eventually lead to oxygen requirements, vomit, seizures and episodes of four-limb twitching. The respiratory failure continued until she was sedated, and ventilation was required (Hung et al., 2003) . SARS-CoV infection was confirmed in both tracheal aspirates and CSF samples, followed by ribavirin treatment, with no improvement in seizures persistence. With additional treatments, seizures were no longer detected, and she was discharged 3 weeks after admission (Hung et al., 2003) . The following year, another case of SARS-CoV infection with detection of genetic material in CSF samples was reported in a 32-year-old woman (Lau et al., 2004 ; Figure 3) . Detection was also positive for stool specimens and peritoneal fluids. FIGURE 3 | Human coronavirus (HCoV) enters the CNS through the olfactory bulb, causing inflammation and demyelination. Upon nasal infection, HCoV can reach the CNS through the olfactory bulb, as ablation of this part of the brain restricts its neurotropic capacities in mice. Once the infection is set, the virus can reach the whole brain and CSF in less than 7 days. Accordingly, it has been described that this virus can induce demyelination. Likewise, primary glial cultures have been described to secrete IL-6, IL-12p40, IL-15, TNF-α, CXCL9 and CXCL10 upon viral infection.