Dyspneic and non-dyspneic (silent) hypoxemia in COVID-19: Possible neurological mechanism

Dyspneic and non-dyspneic (silent) hypoxemia in COVID-19: Possible neurological mechanism


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نویسندگان: مسعود نوری وسکه , اکبر شریفی , علی شریفی

کلمات کلیدی: COVID-19 SARS-CoV-2 Hypoxemia Neural Invasion Central Nervous System

نشریه: 55102 , 0 , 198 , 2020

اطلاعات کلی مقاله
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نویسنده ثبت کننده مقاله اکبر شریفی
مرحله جاری مقاله تایید نهایی
دانشکده/مرکز مربوطه مرکز تحقیقات سل و بیماری های ریوی
کد مقاله 74162
عنوان فارسی مقاله Dyspneic and non-dyspneic (silent) hypoxemia in COVID-19: Possible neurological mechanism
عنوان لاتین مقاله Dyspneic and non-dyspneic (silent) hypoxemia in COVID-19: Possible neurological mechanism
ناشر 5
آیا مقاله از طرح تحقیقاتی و یا منتورشیپ استخراج شده است؟ خیر
عنوان نشریه (خارج از لیست فوق)
نوع مقاله Review Article
نحوه ایندکس شدن مقاله ایندکس شده سطح یک – ISI - Web of Science
آدرس لینک مقاله/ همایش در شبکه اینترنت

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SARS-CoV-2 mainly invades respiratory epithelial cells by adhesion to angiotensin-converting enzyme 2 (ACE-2) and thus, infected patients may develop mild to severe inflammatory responses and acute lung injury. Afferent impulses that result from the stimulation of pulmonary mechano-chemoreceptors, peripheral and central che-moreceptors by inflammatory cytokines are conducted to the brainstem. Integration and processing of these input signals occur within the central nervous system, especially in the limbic system and sensorimotor cortex, and importantly feedback regulation exists between O2, CO2, and blood pH. Despite the intensity of hypoxemia in COVID-19, the intensity of dyspnea sensation is inappropriate to the degree of hypoxemia in some patients (silent hypoxemia). We hypothesize that SARS-CoV-2 may cause neuronal damage in the corticolimbic network and subsequently alter the perception of dyspnea and the control of respiration. SARS-CoV-2 neuronal infection may change the secretion of numerous endogenous neuropeptides or neurotransmitters that distribute through large areas of the nervous system to produce cellular and perceptual effects. SARS-CoV-2 mainly enter to CNS via direct (neuronal and hematologic route) and indirect route. We theorize that SARS-CoV-2 infection-induced neuronal cell damage and may change the balance of endogenous neuropeptides or neurotransmitters that distribute through large areas of the nervous system to produce cellular and perceptual effects. Thus, SARS-CoV- 2-associated neuronal damage may influence the control of respiration by interacting in neuromodulation. This would open up possible lines of study for the progress in the central mechanism of COVID-19-induced hypoxia. Future research is desirable to confirm or disprove such a hypothesis.

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نویسنده نفر چندم مقاله
مسعود نوری وسکهاول
اکبر شریفیپنجم
علی شریفیدوم

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