SARS-CoV-2 Virus Impact on Oligodendrocytes
Increasing evidence indicates that SARS-CoV-2 virus infection is a definite risk factor for demyelination in both the peripheral and central nervous systems. This notion is supported by the description of a COVID-19 patient who was hospitalized for interstitial pneumonia and seizures and then described by Zanin et al. Damage to the demyelin sheath was detected recently, according to a brain MRI. However, high-dose steroid therapy triggered repair in the neurological and respiratory systems. They suggested that a SARS-CoV-2-induced delayed immune response was what led to the degeneration of the myelin sheath (55).
Mehta et al. discovered demyelinating lesions linked to neurological impairment in a COVID-19 case in a different study. The patient’s brain and spine MRIs revealed multiple demyelinating lesions that had recently developed but were not enhancing. They postulated that glial cell activation and subsequent demyelination during SARS-CoV-2 infection would be due to the pro-inflammatory environment caused by the cytokine storm (56). Likewise, encephalomyelitis was reported by Zoghi et al. in a male patient, age 21, who had upper respiratory symptoms two weeks before to this presentation and intermittent vomiting for four days. Brain MRI revealed bilateral posterior internal capsule lesions extending to the ventral part of the pons as well as a marbled splenium hyperintensity pattern. A substantial transverse myelitis was discovered throughout their research using thoracic and cervical MRI (57).
Gilles et al. reported a 54-year-old woman who had been exposed to SARS-CoV-2 and had brain lesions that indicated acute demyelination. The pallidum and supratentorial white matter on both sides of the patient’s brain were afflicted by hypodense lesions, according to the patient’s brain CT scan. Confined diffusion lesions were seen on an MRI of the brain, but there was no bleeding or amplification. Unaffected areas included the striatum, posterior fossa, and thalamus. A follow-up MRI revealed no new abnormalities, and the spinal cord MRI was normal (58). Furthermore, two other studies (59, 60) presented demyelination in patients afflicted with COVID-19; MRI in both studies presented that the corpus callosum and the pericallosal white matter were where the majority of the myelin destruction foci and a concentric demyelination pattern and the presence of hemosiderin deposits together. Given such evidence, SARS-CoV-2 virus is able to cause demyelination in sundry ways.