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Mecanismos neuroinvasivos y del daño neurológico en las infecciones por coronavirus
Resumen
Introducción: En diciembre de 2019, en China, se reportaba un nuevo coronavirus, que se clasificó y denominó como sÃndrome respiratorio agudo severo-coronavirus 2, causante de la enfermedad COVID-19; capaz de provocar sÃntomas y complicaciones neurológicas.
Objetivo: Describir los mecanismos neuroinvasivos y del daño neurológico en las infecciones por coronavirus.
Métodos: De las bases datos PubMed, SciELO y Latindex, se seleccionaron artÃculos publicados desde 2005 hasta mayo de 2020 que trataran: la lesión neurológica directa, la lesión neurológica indirecta y los mecanismos de la muerte neuronal en las infecciones por coronavirus. Se incluyeron estudios en humanos, animales de experimentación y estudios in vitro.
Resultados: Las propiedades neuroinvasivas de los coronavirus está demostrada, pero la fisiopatologÃa que media la neuroinvasión y el daño neurológico en la infección por SARS-CoV-2 no está totalmente aclarada. Las propiedades neurotrópicas del nuevo coronavirus, se demostraron por la presencia del virus en lÃquido cefalorraquÃdeo y cerebro. Los mecanismos que explican el daño neurológico están presentes en los pacientes con formas graves de la COVID-19 y justifican las manifestaciones clÃnicas y complicaciones neurológicas de la enfermedad.
Consideraciones finales: Los coronavirus son neuroinvasivos y neurotrópicos, con potencialidad para provocar enfermedad neurológica. Las hipótesis fisiopatológicas indican que las manifestaciones en el sistema nervioso se deben a causas inflamatorias. Se necesitan estudios a nivel biomolecular para aceptar o refutar tales teorÃas. Esto ayudarÃa a clasificar mejor todo el espectro de la neuropatologÃa y elaborar un consenso sobre las mejores estrategias de diagnóstico y modalidades de tratamiento.
Palabras claves: COVID-19, SARS-CoV-2, neuroinvasión, neurotropismo, daño neurológico, coronavirus.
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