19 June 2021 : Review article
A Review of Neurological Involvement in Patients with SARS-CoV-2 Infection
Yidan Xu12EF, Yu Zhuang12EF, Lumei Kang13AG*DOI: 10.12659/MSM.932962
Med Sci Monit 2021; 27:e932962

Figure 1 Viral journey to the central nervous system (CNS)A. Axonal transport. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been shown in the olfactory epithelium, where they can disseminate along the olfactory nerve, ascending from the cribriform plate into the olfactory bulb, then disseminate throughout the CNS via interconnected neurons. SARS-CoV-2 is also presented in the lungs and the gastrointestinal tract, where they can spread along the vagus nerve to reach the CNS, including the brainstem. B. Hematogenesis dissemination. SARS-CoV-2 first invades peripheral epithelial cells, which express ACE2 and TMPRSS2. Once inside the bloodstream, the virus penetrates through the impaired BBB and invades the CNS. (Created with BioRender.com).