Putative Role of the Lung–Brain Axis in the Pathogenesis of COVID-19-Associated Respiratory Failure: A Systematic Review

Abstract

The emergence of SARS-CoV-2 and its related disease caused by coronavirus (COVID-19) has posed a huge threat to the global population, with millions of deaths and the creation of enormous social and healthcare pressure. Several studies have shown that besides respiratory illness, other organs may be damaged as well, including the heart, kidneys, and brain. Current evidence reports a high frequency of neurological manifestations in COVID-19, with significant prognostic implications. Importantly, emerging literature is showing that the virus may spread to the central nervous system through neuronal routes, hitting the brainstem and cardiorespiratory centers, potentially exacerbating the respiratory illness. In this systematic review, we searched public databases for all available evidence and discuss current clinical and pre-clinical data on the relationship between the lung and brain during COVID-19. Acknowledging the involvement of these primordial brain areas in the pathogenesis of the disease may fuel research on the topic and allow the development of new therapeutic strategies.

Long COVID in Children: A Multidisciplinary Review

“…In particular, whereas several neurological syndromes have been described in 2020, cognitive disturbances seem to characterise the last pandemic outbreaks, both in adults and children, with a focus on visuospatial abilities and executive functions [ 28 , 107 , 108 ]. Similarly, although underlying pathogenetic mechanisms are numerous and heterogeneous, they seem to be shifted from a direct viral invasion towards pro-inflammatory states and a high liability to develop autoimmunity [ 109 ].…”

COVID-19 on Oral Health: A New Bilateral Connection for the Pandemic

“…The study of mucosal antibody kinetics, which may serve as viable targets for diagnostic techniques to find viral exposure, has received little research to date [21,40,75]. The conversion status of antibody levels (IgA, IgM, and IgG) to SARS-CoV-2 spike and nucleocapsid antigens in saliva can be a valuable indicator for screening people for minimal exposure to the virus [200][201][202].…”

Understanding the Pivotal Role of the Vagus Nerve in Health from Pandemics

“…As the N-terminal binding subdomain of many viruses and of neurotoxins facilitates internalization of the virus [ 20 ], after binding to nAChRs, SARS-CoV-2 and HIV-1 could enter the vagus nerve, wherein they induce vagal dysfunctions [ 21 , 22 , 23 , 24 , 25 , 26 , 27 ] before finally invading the brain [ 28 , 29 ]. As a matter of fact, the vagus nerve is a common way for various pathogens to invade the brain [ 30 ].…”