Coronavirus Disease 2019 and Related Parkinsonism: The Clinical Evidence Thus Far

Boura, Iro

doi:10.1002/mdc3.13461

Cited by 23 publications

(25 citation statements)

References 73 publications

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“…To date, only few cases of parkinsonism have been reported in literature following COVID-19 infection [ 19 , 20 , 76 , 77 , 78 ]. In these studies, the authors speculate a possible causative link between COVID-19 infection and a post-COVID new-onset parkinsonian phenotype, but they do not address the possibility of prodromal, pre-symptomatic PD, which became symptomatic as a result of biological or psychological stress processes associated with COVID-19.…”

Section: Sars-cov-2 Infection and Pd Overlapsmentioning

confidence: 99%

Post-COVID-19 Parkinsonism and Parkinson’s Disease Pathogenesis: The Exosomal Cargo Hypothesis

Mysiris

Vavougios

Karamichali

et al. 2022

IJMS

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Parkinson’s disease (PD) is the second most prevalent neurodegenerative disease after Alzheimer’s disease, globally. Dopaminergic neuron degeneration in substantia nigra pars compacta and aggregation of misfolded alpha-synuclein are the PD hallmarks, accompanied by motor and non-motor symptoms. Several viruses have been linked to the appearance of a post-infection parkinsonian phenotype. Coronavirus disease 2019 (COVID-19), caused by emerging severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, has evolved from a novel pneumonia to a multifaceted syndrome with multiple clinical manifestations, among which neurological sequalae appear insidious and potentially long-lasting. Exosomes are extracellular nanovesicles bearing a complex cargo of active biomolecules and playing crucial roles in intercellular communication under pathophysiological conditions. Exosomes constitute a reliable route for misfolded protein transmission, contributing to PD pathogenesis and diagnosis. Herein, we summarize recent evidence suggesting that SARS-CoV-2 infection shares numerous clinical manifestations and inflammatory and molecular pathways with PD. We carry on hypothesizing that these similarities may be reflected in exosomal cargo modulated by the virus in correlation with disease severity. Travelling from the periphery to the brain, SARS-CoV-2-related exosomal cargo contains SARS-CoV-2 RNA, viral proteins, inflammatory mediators, and modified host proteins that could operate as promoters of neurodegenerative and neuroinflammatory cascades, potentially leading to a future parkinsonism and PD development.

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Section: Sars-cov-2 Infection and Pd Overlapsmentioning

confidence: 99%

Post-COVID-19 Parkinsonism and Parkinson’s Disease Pathogenesis: The Exosomal Cargo Hypothesis

Mysiris

Vavougios

Karamichali

et al. 2022

IJMS

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“…Characteristics of patients with new-onset post-COVID-19 parkinsonism(Boura and Chaudhuri 2022) National Institute for Health and Care Excellence in the United Kingdom as signs and symptoms that occur during or after an infection consistent with COVID-19, persisting for more than 12 weeks which are not explained by an alternative diagnosis…”

mentioning

confidence: 99%

Viruses, parkinsonism and Parkinson’s disease: the past, present and future

Leta,

Urso,

Batzu

et al. 2022

J Neural Transm

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Parkinsonism secondary to viral infections is not an uncommon occurrence and has been brought under the spotlight with the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A variety of viruses have been described with a potential of inducing or contributing to the occurrence of parkinsonism and Parkinson’s disease (PD), although the relationship between the two remains a matter of debate originating with the description of encephalitis lethargica in the aftermath of the Spanish flu in 1918. While some viral infections have been linked to an increased risk for the development of PD, others seem to have a causal link with the occurrence of parkinsonism. Here, we review the currently available evidence on viral-induced parkinsonism with a focus on potential pathophysiological mechanisms and clinical features. We also review the evidence on viral infections as a risk factor for developing PD and the link between SARS-CoV-2 and parkinsonism, which might have important implications for future research and treatments.

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“…SARS-CoV-2 could enter the nasal cavity, then the olfactory bulb and the piriform cortex, and finally the brainstem, where the substantia nigra pars compacta is located [ 84 ]. Because the blood–brain barrier is absent in the olfactory bulb, viral entry is made easier [ 14 ]. A recent study revealed that COVID-19 infection was associated with reduced gray matter thickness in the parahippocampal gyrus and orbitofrontal cortex, as well as changes in brain areas with a functional connection to the primary olfactory cortex [ 85 ].…”

Section: Ace2 In Pd and Covid-19: Connecting The Dotsmentioning

confidence: 99%

“…There are some cases of parkinsonism related to COVID-19 that occurred shortly after or concurrently with the infectious disease, representing potential post-viral parkinsonian syndromes. Some of these cases also showed evidence of nigrostriatal pathway deficits in the functional imaging, suggesting potential dopaminergic degeneration [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Exploring the Role of ACE2 as a Connecting Link between COVID-19 and Parkinson’s Disease

Angelopoulou

Karlafti

Georgakopoulou

et al. 2023

Life

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Coronavirus disease 2019 (COVID-19) is frequently accompanied by neurological manifestations such as headache, delirium, and epileptic seizures, whereas ageusia and anosmia may appear before respiratory symptoms. Among the various neurological COVID-19-related comorbidities, Parkinson’s disease (PD) has gained increasing attention. Some cases of PD disease have been linked to COVID-19, and both motor and non-motor symptoms in Parkinson’s disease patients frequently worsen following SARS-CoV-2 infection. Although it is still unclear whether PD increases the susceptibility to SARS-CoV-2 infection or whether COVID-19 increases the risk of or unmasks future cases of PD, emerging evidence sheds more light on the molecular mechanisms underlying the relationship between these two diseases. Among them, angiotensin-converting enzyme 2 (ACE2), a significant component of the renin-angiotensin system (RAS), seems to play a pivotal role. ACE2 is required for the entry of SARS-CoV-2 to the human host cells, and ACE2 dysregulation is implicated in the severity of COVID-19-related acute respiratory distress syndrome (ARDS). ACE2 imbalance is implicated in core shared pathophysiological mechanisms between PD and COVID-19, including aberrant inflammatory responses, oxidative stress, mitochondrial dysfunction, and immune dysregulation. ACE2 may also be implicated in alpha-synuclein-induced dopaminergic degeneration, gut–brain axis dysregulation, blood–brain axis disruption, autonomic dysfunction, depression, anxiety, and hyposmia, which are key features of PD.

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Coronavirus Disease 2019 and Related Parkinsonism: The Clinical Evidence Thus Far

Cited by 23 publications

References 73 publications

Post-COVID-19 Parkinsonism and Parkinson’s Disease Pathogenesis: The Exosomal Cargo Hypothesis

Post-COVID-19 Parkinsonism and Parkinson’s Disease Pathogenesis: The Exosomal Cargo Hypothesis

Viruses, parkinsonism and Parkinson’s disease: the past, present and future

Exploring the Role of ACE2 as a Connecting Link between COVID-19 and Parkinson’s Disease

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