Review of the pathogenesis, clinical manifestations and peculiarities of neuropsychic disorders caused by COVID-19

The article presents literature data numerous studies of patients with COVID-19. The available information helps to explain the nature and structure of the virus, the ways of penetration and its distribution in the human body, its interaction with the immune, nervous, endocrine, vascular, muscular systems, as well as the pathogenesis, clinic, diagnosis and treatment of this contingent of patients. Due to tropisms SARS-CoV-2 to the human cells specifi c S glycoprotein this virus can bind receptor human angiotensin-converting enzyme 2 (ACE-2), fuse with host cells and disseminate in the organism. Renin-angiotensin-aldosteron system (RAAS) plays an important role in regulation of blood vessels, heart, kidneys functions. ACE-2 has an infl uence on the infl ammatory, fi brotic and immunomodulatory mechanisms. Inhibition of these protection functions due to spread SARS-CoV-2 in human body leads to the progression of cardiovascular, renal and pulmonary diseases. Some authors describe indirectly the viral entry into the brain parenchyma by infecting the T-lymphocytes, that usually is accompanied by infl ammatory reactions with an increase in the specifi c cytokines such as interleukins (IL) — 6, IL-8, tumor necrosis factor, monocyte chemoattractant protein-1 (MCP-1). The peculiarities of the binding of the virus to the human cells are the presence of neurotropic properties and the ability to change the permeability of blood brain barier (BBB). Other authors note that the virus crosses the BBB directly through the olfactory neurons and also the brain’s circumventricular organs structures, surrounding the third and fourth ventricles, and promote the infection of nervous system. It can also cause intravascular coagulation and blood clotting, which may lead to various diseases of the nervous system. In this regard, an important task for neurologists is to further study the eff ect of the COVID-19 virus on the nervous system and prevent the occurrence of its complications.