CORONAVIRUS AND ITS EFFECTS ON

BRAIN HEALTH
By
Lawrence OBASI
(U17AN1012)

SUPERVISOR:
DR. Z. M. BAUCHI

Department of Human Anatomy,

Faculty of Basic Medical Sciences,
Ahmadu Bello University, Zaria

March, 2022
 OUTLINE
• Introduction
• History of Coronavirus
• Types of Coronaviruses
• Signs and Symptoms
• Neurological Manifestations
• Psychological/Psychiatric Manifestations
• Management & Treatments
• Conclusion
• References
 INTODUCTION
• SARS-CoV-2 is a respiratory infection that was first detected in December
2019 in Wuhan, China and it primarily weakens human’s immune system
(Tewari et al., 2020).

• The World Health Organization named it 2019-nCoV while the International

Committee on Virus Taxonomy named it SARS-CoV-2 (Lintau et al., 2021).

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 HISTORY OF CORONAVIRUS
• By 1960s, scientists evidence the presence of coronavirus in the nose of
people with common cold.

• In November 2002, the SARS-CoV was discovered in Guang-Dong province

in southern China and reached to Hong Kong and was reported in other 29
countries in North America, South America, Europe, and Asia.

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 HISTORY OF CORNAVIRUS…
• By 2012, MERS-CoV was recognized in Saudi Arabia and moved to USA and
then to South Korea in 2015.

• In December, 2019 the recent SARS-CoV-2(COVID-19) first broke out in

Wuhan, China and has been spreading all over the world.

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 TYPES OF CORONAVIRUSES
• 229E (alpha)
• NL63 (alpha)
• OC43 (beta)
• HKU1 (beta)
• MERS-CoV
• SARS-CoV
• SARS-CoV-2

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CORONAVIRUS SYMPTOMS

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 NEUROLOGICAL MANIFESTATIONS
• It is estimated that more than 1/3 of COVID-19 patients will have central
nervous system symptoms such as dizziness, headache, disturbance of
consciousness, acute cerebrovascular disease, ataxia, epilepsy (Mao et al.,
2020).

• Peripheral nervous system symptoms (taste disorder, olfactory disorder,

visual impairment, neuralgia) (Mao et al., 2020).

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 NEUROLOGICAL MANIFESTATIONS…
• The possible pathways of SARS-CoV-2 invasion into the central nervous
system include; direct invasion of infected endothelial cells, invasion
through the olfactory nerve, and invasion by inducing inflammation to
destroy the brain barrier system (Wang et al., 2021).

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 NEUROLOGICAL MANIFESTATIONS…
DIRECT INVASION OF INFECTED ENDOTHELIAL CELLS
• SARS-CoV-2 directly infects vascular endothelial cells by means of
angiotensin converting enzymes 2, thus directly cross the BBB (Lintao et al.,
2021).

• S protein is the main tool for SARS-CoV-2 to bind to the ACE2 receptor
(infect cells), and it can strongly bind to ACE2 (Hassanzade et al., 2020).

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 NEUROLOGICAL MANIFESTATIONS…
INVATION THROUGH THE OLFACTORY NERVE
• Since SARS-CoV-2 can directly act on nasal respiratory epithelial cells in the
nasal cavity, olfactory dysfunction often occurs in the early stages of the
disease (Fasunla and Ibekwu, 2020).

• In mild to moderate cases, sudden loss of smell and taste is considered to

be the strongest predictive symptom of early infection with the SARSCoV-2
virus (Fasunla and Ibekwu, 2020).

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 NEUROLOGICAL MANIFESTATIONS…
INVATION THROUGH THE OLFACTORY NERVE
• The olfactory dysfunction caused by SARS-CoV-2 may be explained by the following
four mechanisms:

I. Viral infections of the nasal mucosa can trigger inflammation of the nasal tissue,
including the olfactory mucosa, thereby creating an obstructive barrier between odor
chemicals and olfactory receptors.

II. Direct damage to olfactory receptors could prevent odor signals from being
transmitted.
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NEUROLOGICAL MANIFESTATIONS…

INVATION THROUGH THE OLFACTORY NERVE

III. The virus, being neurotropic, can attack the area of the brain responsible
for smell along the path of the olfactory nerve.

IV. Loss of sense of smell may actually be a sequela of brain edema and
partial neurodegeneration. Any or all of these four mechanisms may lead to
loss of sense of smell in COVID-19.
(Kadono et al., 2020).

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 NEUROLOGICAL MANIFESTATIONS…
INVASION BY INDUCING INFLAMMATION TO DESTROY THE BBB
• COVID-19 infection is accompanied by an aggressive inflammatory
response with the release of a large amount of pro-inflammatory cytokines
in an event known as “Cytokine storm” (Ragab et al., 2020).

• The host immune response to the SARS-CoV-2 virus is hyperactive resulting

in an excessive inflammatory reaction (Ragab et al., 2020).

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 NEUROLOGICAL MANIFESTATIONS…
INVASION BY INDUCING INFLAMMATION TO DESTROY THE BBB
• Infection with SARS-CoV-2 can destroy the blood-brain barrier by producing
a large number of inflammatory mediators in the following three ways:
1. SARS-CoV-2 Directly Induces the Release of Cytokines by Immune Cells
2. SARS-CoV-2 can cause immune cells to produce excessive immunity
3. Activation of Glial Cells Releases Proinflammatory Cytokines

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 PSYCHOLOGICAL MANIFESTATIONS
• Good brain health is a state in which every individual can realize their own
abilities and optimize their cognitive, emotional, psychological and
behavioural functioning to cope with life situations (WHO, 2022).

• As COVID-19 is a disease that directly threatens life, concerns of getting

infected and sleep disorders (like insomnia) were reported in the general
population (Lin et al., 2020).

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PSYCHOLOGICAL MANIFESTATIONS…
• The COVID-19 outbreak has also been reported to be associated with an
increased risk of mental health disorders like depression, anxiety,
schizophrenia, obsessive compulsive symptoms, delirium, mood disorders,
and phobia (Arpaci et al., 2020).

• It also leads to an increase in anger, alcohol/tobacco abuse, divorce,

domestic violence, and suicide (Ausin et al., 2020).

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PSYCHOLOGICAL MANIFESTATIONS…
• Women may also have limited access to acute and emergency reproductive
services forcing many women to travel long distances to safe medical
facilities or have their child delivered at home in developing countries
(Hussein, 2020).

• As a result, the females are associated with a more significant

psychological impact leading to higher levels of stress, anxiety, and
depression (Liu et al., 2020).

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PSYCHOLOGICAL MANIFESTATIONS…
• Research shows that migrants, divorced or widowed people, and ones
isolated or quarantined, are also among the group of people at high risk of
psychological distress.

• Retrospective meta-analysis of SARS and MERS outbreaks has revealed

acute and long-term neuropsychological deficits (Rogers et al., 2020).

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 MANAGEMENT & TREATMENTS
• Self-protection & strict adherence to safety protocols
• Vaccination against COVID-19
• Telemedicine
• Immunosuppressive therapy
• Communication with loved ones
• Protecting Psychiatric Staff
• Psycho-education and Information
• Uninterrupted Care
• Psychopharmacology & Psychotherapy
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 SUMMARY
• COVID-19 is a pandemic ravaging the whole world and have led to the loss of
millions of lives.

• Patients surviving COVID-19 are at high risk for subsequent development of

neurological diseases and psychological complications affecting mental health.

• Neurologists, neuroscientists, psychiatrists, and caregivers should be alerted to

a possible increase in such cases in COVID-19 survivors and further studies are
needed to investigate potential complications.
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