Unmasking COVID-19’s Impact on the Mind

Oct, 2020

As scientists worldwide work tirelessly to understand SARS-CoV-2, surprising new evidence has emerged regarding the virus’s ability to invade areas far beyond the lungs. A collective analysis of current findings reveals COVID-19 may exert worrying effects on the most complex organ of all – the human brain.

Neurological Presentations

Initial reports from hospitals overflowing with patients illuminated a diversity of neuropsychiatric presentations accompanying pulmonary symptoms. Dizziness, headaches and alterations in consciousness were among the most frequently noted signs. Yet for some, the virus appeared to trigger rarer yet grave conditions such as strokes, autoimmune nerve disorders, inflammation of the brain and spinal cord, and a rapid worsening encephalopathy unrelated to lung function.

Post-mortem examinations have lent credence to fears of direct central nervous system (CNS) involvement, detecting viral genetic material within neural cells. This parallels predecessor SARS-CoV, known to access brain areas during that crisis as well. Such discoveries help explain respiratory failures in COVID-19 patients exhibiting sound respiratory anatomy.

Routes of Neurotropic transit

Given SARS-CoV-2’s close link to past coronaviruses, scientists hypothesize comparable pathways allowing neuroinvasion. Primary suspicion falls upon the olfactory system, major CNS entry-point utilized by other respiratory viruses. However, further potential routes under investigation include hijacking of immune cells enabling transport through the brain’s lymphatic equivalent or spread through breaches in the blood-brain barrier via interactions with endothelial proteins.

Inflammation’s Toll

Analysis stresses both the virus’s own actions within nerve networks and overactivation of the immune response may wreak havoc in the organ responsible for identity, intelligence and more. Even lacking proof of direct access, sterile inflammation alone could mimic encephalitic presentations. Longer term, surviving such episodes often leaves scarring and neuron demise as seen previously in animal coronaviruses.

Unraveling COVID-19’s intricacies will require ongoing cooperation. But acknowledging its capacity to endanger brain health allows for improved care of neurologically troubled patients and hints at future therapeutic avenues targeting vulnerable entry-points or downstream consequences of infection. Continued surveillance may also reveal often subtle long-term sequelae as survivors commence their recoveries.


  1. https://doi.org/10.1007/s12035-020-02070-6>DOI: 


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About the Author

  • Dilruwan Herath

    Dilruwan Herath is a British infectious disease physician and pharmaceutical medical executive with over 25 years of experience. As a doctor, he specialized in infectious diseases and immunology, developing a resolute focus on public health impact. Throughout his career, Dr. Herath has held several senior medical leadership roles in large global pharmaceutical companies, leading transformative clinical changes and ensuring access to innovative medicines. Currently, he serves as an expert member for the Faculty of Pharmaceutical Medicine on it Infectious Disease Commitee and continues advising life sciences companies. When not practicing medicine, Dr. Herath enjoys painting landscapes, motorsports, computer programming, and spending time with his young family. He maintains an avid interest in science and technology. He is a founder of DarkDrug

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