Nervous system involvement after infection with COVID-19 and other coronaviruses
Open accessAbstract
Highlights • Coronoviruses not only affect the respiratory system, but also have deleterious effects on the central nervous system.• Most neurological diseases could be caused by coronoviruses invasion.• Coronoviruses cause nerve damage via diverse pathways.
AI snapshot
Written from the paper’s full text.
TL;DR
This narrative review summarizes evidence that coronaviruses—SARS-CoV, MERS-CoV, and SARS-CoV-2—can affect the central nervous system, causing encephalitis, infectious toxic encephalopathy, and acute cerebrovascular disease. It proposes direct infection (blood and neuronal/olfactory routes), hypoxia, immune injury, and ACE2-mediated mechanisms as pathways of neuroinvasion.
Key findings
- Neurological involvement is common in COVID-19: 36.4% (78/214) of patients developed neurological symptoms (headache, disturbed consciousness, paresthesia), with severely affected patients more likely to do so; nearly 40% develop headache and other brain dysfunction symptoms (citing Mao et al., 2020).
- MERS-CoV is potentially neuroinvasive: a retrospective study found 25.7% of MERS patients developed insanity and 8.6% had seizures; Kim et al. reported almost 1/5 show neurological symptoms, sometimes delayed 2–3 weeks and without accompanying respiratory symptoms.
- SARS-CoV-2 shares 79.5% genetic similarity with SARS-CoV and up to 96% with bat coronavirus; COVID-19 mortality is reported at 2%–4%. SARS-CoV-2 was confirmed in cerebrospinal fluid by genome sequencing in a Beijing Ditan Hospital encephalitis case.
- Proposed damage mechanisms: direct CNS invasion via blood circulation or neuronal (olfactory) pathways, hypoxia injury from lung pathology, immune injury via SIRS/cytokine storm (IL-6 correlated with COVID-19 severity), and ACE2-mediated blood–brain barrier damage.
Methods
- Design: narrative literature review of epidemiology, mechanisms of neuroinvasion, and management strategies for CoV infections with nervous system involvement.
- Data: no primary data; the paper synthesizes published case reports, autopsy studies, retrospective series, and mechanistic studies on SARS-CoV, MERS-CoV, and SARS-CoV-2, including several 2020 preprints and news sources.
- Analysis: descriptive/thematic synthesis organized by virus type, neurological disease category, and proposed mechanism; includes two schematic figures.
Limitations
- Not stated in the paper: the review does not include a limitations section.
- Evident from the text: it is a non-systematic narrative review without stated search strategy or inclusion criteria; several key claims rest on preprints, single case reports, news media, and animal/in vitro studies; mechanistic pathways (e.g., blood circulation route) are explicitly described as lacking evidence ("rare evidence that CoV... invade the nervous system via the blood circulation pathway"), and the authors repeatedly call for further study.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Cites
Statistics
Claims the paper makes
0 of 65 cited sources checked · 0 supported · 0 flagged
- Interpretationreasoning
Coronaviruses cause nerve damage via diverse pathways.
“Coronoviruses cause nerve damage via diverse pathways.”
- Also stated in: § Others · plain
“The coronaviruses can cause nerve damage through direct infection pathways (blood circulation pathways and neuronal pathways), hypoxia, immune injury, ACE2, and other mechanisms.”
Quote in the paperSubstantial claim - Also stated in: § Others · plain
- Premisecitation
Autopsy reports have revealed brain tissue edema and partial neuronal degeneration in deceased COVID-19 patients.
“Additionally, autopsy reports have revealed brain tissue edema and partial neuronal degeneration in deceased patients (Xu et al., 2020).”
- Also stated in: § Infectious toxic encephalopathy · plain
“an autopsy study reported that edema has been detected in brain tissue of COVID-19 patients (Xu et al., 2020)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Xu et al., 2020
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- Also stated in: § Infectious toxic encephalopathy · plain
- Premisecitation
A growing number of COVID-19 patients report a sudden loss of smell or taste.
“Moreover, a growing number of COVID-19 patients report a sudden loss of smell or taste.”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites Giacomelli et al., 2020
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- cites Ryan, 2020
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- cites Hopkins and Kumar, 2020
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- Premisecitation
36.4% (78/214) of patients with COVID-19 develop neurological symptoms, including headache, disturbed consciousness, and paresthesia.
“It was recently documented that, in addition to systemic and respiratory symptoms, 36.4% (78/214) of patients with COVID-19 develop neurological symptoms, including headache, disturbed consciousness, and paresthesia.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Mao et al., 2020
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- Premisecitation
Autopsy studies of SARS demonstrated cerebral edema and meningeal vasodilation in most cases.
“Autopsy studies demonstrated that signs of cerebral edema and meningeal vasodilation could be detected in most cases of SARS.”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Gu et al., 2005
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- cites Zhang et al., 2003
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- Premisecitation
Severely affected COVID-19 patients are more likely to develop neurological symptoms than patients with mild or moderate disease.
“Severely affected patients are more likely to develop neurological symptoms than patients who have mild or moderate disease (Mao et al., 2020).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Mao et al., 2020
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- Interpretationcitation
COVID-19 has the potential to cause nervous system damage.
“It illustrated that COVID-19 has potential to cause nervous system damage (Xiang et al., 2020).”
- Also stated in: § SARS-CoV-2 · plain
“adding support to the theory this new pneumonia virus can also cause nervous system damage (Xiang et al., 2020)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Xiang et al., 2020
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- Also stated in: § SARS-CoV-2 · plain
- Premisecitation
Almost 1/5 of patients with MERS-CoV infection show neurological symptoms during the infection process.
“Kim et al. also reported that almost 1/5 of patients with MERS-CoV infection show neurological symptoms during the infection process, including but not limited to disturbance of consciousness, paralysis, ischemic stroke, Guillain-Barre syndrome and other poisoning or infectious neuropathy.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Kim et al., 2017 source
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- Premisecitation
A case of viral encephalitis caused by SARS-CoV-2 attacking the CNS was reported by Beijing Ditan Hospital, with SARS-CoV-2 confirmed in cerebrospinal fluid by genome sequencing.
“Furthermore, on March 4, 2020, Beijing Ditan Hospital reported for the first time a case of viral encephalitis caused by a novel coronavirus (CoV) attacking the central nervous system (CNS). The researchers confirmed the presence of SARS-CoV-2 in the cerebrospinal fluid by genome sequencing.”
- Also stated in: § Viral encephalitis · boosted
“In the ongoing pneumonia epidemic, the treatment team of Beijing Ditan Hospital confirmed the presence of SARS-CoV-2 in the cerebrospinal fluid of patients with COVID-19 by genome sequencing, thereby clinically verifying viral encephalitis (Xiang et al., 2020).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Xiang et al., 2020
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- Also stated in: § Viral encephalitis · boosted
- Premisecitation
MERS-CoV is potentially neuroinvasive.
“MERS-CoV is known to be potentially neuroinvasive”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Saad et al., 2014 source
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- Premisecitation
SARS-CoV can induce neurological diseases such as polyneuropathy, encephalitis, and aortic ischemic stroke.
“In addition, SARS-CoV could induce neurological diseases such as polyneuropathy, encephalitis, and aortic ischemic stroke (Tsai et al., 2005).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Tsai et al., 2005
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- Premisecitation
Removal of the olfactory bulb in mice resulted in restricted invasion of CoV into the CNS.
“However, removal of the olfactory bulb in the mice, resulted in a restricted invasion of CoV into the CNS (Bohmwald et al., 2018).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Bohmwald et al., 2018 source
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- Rests on an assumption: Findings from animal models (e.g., mice) about CoV neuroinvasion via the olfactory pathway apply to humans.
- Premisecitation
Some COVID-19 patients develop COVID-19-related symptoms only after showing neurologic symptoms.
“In fact, some even develop COVID-19-related symptoms only after showing neurologic symptoms (Mao et al., 2020).”
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- Premisecitation
Almost 40% of patients with COVID-19 develop headache, disturbed consciousness, and other brain dysfunction symptoms.
“Moreover, almost 40% of patients with COVID-19 develop headache, disturbed consciousness, and other brain dysfunction symptoms (Mao et al., 2020)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Mao et al., 2020
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- Interpretationcitation
These coagulation abnormalities may render severe COVID-19 patients prone to acute cerebrovascular events.
“which may render these patients prone to acute cerebrovascular events”
Quote in the paperSubstantial claim - Premisecitation
Patients with COVID-19 often suffer from severe hypoxia.
“Patients with COVID-19 often suffer from severe hypoxia and viremia (Guo et al., 2020)”
- Also stated in: § Hypoxia injury · plain
“Owing to the fact that the patients with COVID-19 often suffer from severe hypoxia (Guo et al., 2020)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Guo et al., 2020
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- Also stated in: § Hypoxia injury · plain
- Premisecitation
There is rare evidence that CoV, especially SARS-CoV-2, invade the nervous system via the blood circulation pathway.
“Although there is rare evidence that CoV, especially SARS-CoV-2, invade the nervous system via the blood circulation pathway (Koyuncu et al., 2013, Desforges et al., 2019), subsequent studies are expected.”
Quote in the paperNot a substantial claim0 of 2 sources checked - Premisecitation
Genetic material and proteins of various viruses can often be detected in nervous system tissue samples.
“The genetic material and even proteins of various viruses can often be detected in nervous system tissue samples (such as cerebrospinal fluid or brain), suggesting that viruses can directly invade the nervous system and cause nerve damage (Koyuncu et al., 2013, Leber et al., 2016).”
Quote in the paperSubstantial claim0 of 2 sources checked - Interpretationreasoning
Anosmia and dysgeusia might be observed in patients with COVID-19.
“It is therefore likely that anosmia and dysgeusia might be observed in patients with COVID-19 (Giacomelli et al., 2020, Ryan, 2020, Hopkins and Kumar, 2020).”
Quote in the paperSubstantial claim0 of 3 sources checked- cites Giacomelli et al., 2020
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- cites Ryan, 2020
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- cites Hopkins and Kumar, 2020
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- Premisecitation
Patients with COVID-19 often suffer from viremia.
“Patients with COVID-19 often suffer from severe hypoxia and viremia (Guo et al., 2020)”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Guo et al., 2020
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- Premisecitation
SARS virus particles and genome sequences were detected in brain neurons.
“Gu et al. also detected SARS virus particles and genome sequences in brain neurons (Gu et al., 2005).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Gu et al., 2005
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- Interpretationreasoning
Severe hypoxia and viremia have the potential to cause toxic encephalopathy in COVID-19 patients.
“which has the potential to cause toxic encephalopathy”
Quote in the paperSubstantial claim - Interpretationcitation
SARS-CoV-2 can cause viral encephalitis.
“This provided a solid basis for CoV causing the encephalitis.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Xiang et al., 2020
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- Premisecitation
Respiratory-related infection is an independent risk factor for acute cerebrovascular disease.
“A considerable amount of evidence indicates that especially respiratory-related infection is an independent risk factor for acute cerebrovascular disease (Elkind, 2007, Warren-Gash et al., 2018).”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
CoV can enter the brain through the olfactory tract in the early stages of infection or nasal vaccination.
“As a consequence, CoV can enter the brain through the olfactory tract in the early stages of infection or nasal vaccination (Desforges et al., 2019, Mori, 2015).”
Quote in the paperSubstantial claim0 of 2 sources checked - Premisecitation
CoV infections, especially SARS-CoV-2, cause cytokine storm syndromes.
“The infection of CoV, especially SARS-CoV-2, has been widely reported to cause cytokine storm syndromes”
Quote in the paperSubstantial claim0 of 2 sources checked- cites Mehta et al., 2020
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- cites Chen et al., 2020
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- Premisecitation
Neuronal pathway is important vehicles for neurotropic viruses to enter the CNS.
“Neuronal pathway is important vehicles for neurotropic viruses to enter the CNS.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Swanson and McGavern, 2015
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- Interpretationcitation
Cytokine storm syndromes may be one of the factors that CoV cause acute cerebrovascular disease.
“which may be one of the factors that CoV cause acute cerebrobasilar disease”
Quote in the paperSubstantial claim - Interpretationreasoning
COVID-19 could cause infectious toxic encephalopathy.
“Collectively, these findings provide the evidence that COVID-19 could cause infectious toxic encephalopathy, although detailed studies are greatly required.”
Quote in the paperSubstantial claim - Interpretationreasoning
Hypoxia may induce acute cerebrovascular disease such as acute ischemic stroke in patients at particular risk.
“In addition, for patients at particular risk of developing cerebrovascular disease, hypoxia may also induce the occurrence of acute cerebrovascular disease such as acute ischemic stroke.”
Quote in the paperSubstantial claim - Premisecitation
CoV can infect macrophages, microglia, and astrocytes in the CNS.
“The persistence of CoV infections and its ability to infect macrophages, microglia, and astrocytes in the CNS are particularly important.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Li et al., 2004
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- Premisecitation
IL-6 is positively correlated with the severity of COVID-2019 symptoms.
“interleukin (IL)-6, an important member of the cytokine storm, is positively correlated with the severity of COVID-2019 symptoms (Wan et al., 2020).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wan et al., 2020
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- Premisecitation
SIRS could be abnormally initiated in severe pneumonia caused by CoV infection.
“SIRS could be abnormally initiated in severe pneumonia caused by CoV infection, while early anti-inflammatory intervention effectively prevent immune damage and reduce the risk of injury in the nervous system (Mehta et al., 2020, Fu et al., 2010).”
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- cites Fu et al., 2010
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- Premisecitation
Apoptosis of mature neurons after virus infection has a relatively protective effect.
“however, the apoptosis of mature neurons after virus infection also has a relatively protective effect (Wuthrich et al., 2015).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wuthrich et al., 2015 source
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- Premisecitation
Nervous system damage caused by viral infection may be mediated by the immune system.
“Nervous system damage caused by viral infection may be mediated by the immune system (Klein et al., 2017).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Klein et al., 2017 source
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- Interpretationcitation
Hypoxia injury may cause subsequent nervous system damage in COVID-19 patients.
“Owing to the fact that the patients with COVID-19 often suffer from severe hypoxia (Guo et al., 2020), hypoxia injury may cause subsequent nervous system damage.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Guo et al., 2020
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- Premisecitation
ACE2 is an important target for various CoV and influenza viruses.
“Meanwhile, ACE2 is also an important target for various CoV and influenza viruses (Turner et al., 2004, Wrapp et al., 2020, Yang et al., 2014).”
Quote in the paperSubstantial claim0 of 3 sources checked - Interpretationreasoning
CoV in concert with host immune mechanisms may turn these infections into persistent infections that may lead to neurological diseases.
“it is currently believed that CoV in concert with host immune mechanisms may turn these infections into persistent infections that may lead to neurological diseases.”
Quote in the paperNot a substantial claim - Premisecitation
Primary glial cells cultured in vitro secrete a large amount of inflammatory factors such as IL-6, IL-12, IL-15, and TNF-α after being infected with CoV.
“Additionally, experiments have confirmed that primary glial cells cultured in vitro secrete a large amount of inflammatory factors such as IL-6, IL-12, IL-15, and TNF-α after being infected with CoV (Bohmwald et al., 2018).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Bohmwald et al., 2018 source
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- Rests on an assumption: In vitro findings on glial cell cytokine secretion after CoV infection apply to human CNS immune injury.
- Premisecitation
If a virus gains access to the CNS, it is difficult to remove.
“However, if a virus gains access to the CNS, it is difficult to remove (Reinhold and Rittner, 2017).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Reinhold and Rittner, 2017
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- Interpretationcitation
The biological properties of the CNS may facilitate exacerbation of the neurological damage caused by CoV infections.
“The biological properties of the CNS may facilitate exacerbation of the neurological damage caused by CoV infections.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Reinhold and Rittner, 2017
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- Interpretationreasoning
Activation of immune cells in the brain will cause chronic inflammation and brain damage.
“Furthermore, activation of immune cells in the brain will cause chronic inflammation and brain damage.”
Quote in the paperSubstantial claim- Rests on an assumption: In vitro findings on glial cell cytokine secretion after CoV infection apply to human CNS immune injury.
- Interpretationreasoning
CoV can invade the CNS from the periphery through neural pathways.
“The observations mentioned here indicate that CoV can invade the CNS from the periphery through neural pathways.”
Quote in the paperSubstantial claim- Rests on an assumption: Findings from animal models (e.g., mice) about CoV neuroinvasion via the olfactory pathway apply to humans.
- May combine two claims. 16
- Classified as probably not a substantial claim. 2
May combine two claims.
PremisecitationNeurological complications in MERS-CoV patients are not accompanied by respiratory symptoms but delayed by 2-3 weeks.
“Interestingly, their neurological complications are not accompanied by respiratory symptoms, but delayed by 2–3 weeks (Kim et al., 2017).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Kim et al., 2017 source
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Premisecitation25.7% of patients with MERS develop insanity and 8.6% have seizures.
“a retrospective study found that 25.7% of patients with MERS can develop insanity and 8.6% of patients have seizures (Saad et al., 2014).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Saad et al., 2014 source
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Probably not a substantial claim: may not pass S4 (based).
Interpretationnone givenMost neurological diseases could be caused by coronavirus invasion.
“Most neurological diseases could be caused by coronoviruses invasion.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationIn SARS autopsy studies, infiltration of monocytes and lymphocytes in vessel wall, ischemic changes of neurons, demyelination of nerve fibers, and SARS-CoV virus particles and genome sequences were detected in the brain.
“Furthermore, infiltration of monocytes and lymphocytes in the vessel wall, ischemic changes of neurons, demyelinationn of nerve fibers, as well as SARS-CoV virus particles and genome sequences could be detected in the brain (Gu et al., 2005, Zhang et al., 2003).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Gu et al., 2005
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- cites Zhang et al., 2003
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Interpretationnone givenCoronaviruses have deleterious effects on the central nervous system, in addition to affecting the respiratory system.
“Coronoviruses not only affect the respiratory system, but also have deleterious effects on the central nervous system.”
- Also stated in: § Conclusion · plain
“CoV infections can affect the nervous system”
Quote in the paperSubstantial claim- Also stated in: § Conclusion · plain
May combine two claims.
PremisecitationAfter CoV infects nasal cells, it can reach the entire brain and cerebrospinal fluid through the olfactory nerve and olfactory bulb within 7 days and cause inflammation and demyelinating reaction.
“For example, after CoV infects nasal cells, it can reach the entire brain and cerebrospinal fluid through the olfactory nerve and olfactory bulb within 7 days and cause inflammation and demyelinating reaction.”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Bohmwald et al., 2018 source
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- Rests on an assumption: Findings from animal models (e.g., mice) about CoV neuroinvasion via the olfactory pathway apply to humans.
May combine two claims.
PremisecitationInfluenza virus can aggravate ischemic brain injury by triggering a cytokine cascade and increase the risk of cerebral hemorrhage after treatment with tissue-type plasminogen activator.
“Data from the use of experimental mouse models suggests that influenza virus can aggravate ischemic brain injury by triggering a cytokine cascade and increase the risk of cerebral hemorrhage after treatment with tissue-type plasminogen activator (Muhammad et al., 2011).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Muhammad et al., 2011 source
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InterpretationcitationViruses can directly invade the nervous system and cause nerve damage.
“suggesting that viruses can directly invade the nervous system and cause nerve damage (Koyuncu et al., 2013, Leber et al., 2016).”
Quote in the paperSubstantial claim0 of 2 sources checkedMay combine two claims.
PremisecitationCritically ill patients with severe SARS-CoV-2 infections often show elevated levels of D-dimer and severe platelet reduction.
“In addition, critically ill patients with severe SARS-CoV-2 infections often show elevated levels of D-dimer and severe platelet reduction, which may render these patients prone to acute cerebrovascular events (Wang et al., 2020).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Wang et al., 2020
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PremisecitationACE2 is a cardio-cerebral vascular protection factor existing in a variety of organs, including the nervous system and skeletal muscles, playing a major role in regulating blood pressure and anti-atherosclerosis mechanisms.
“Angiotensin-converting enzyme 2 (ACE2) is a cardio-cerebral vascular protection factor existing in a variety of organs, including the nervous system and skeletal muscles, playing a major role in regulating blood pressure and anti-atherosclerosis mechanisms (Miller and Arnold, 2019).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Miller and Arnold, 2019
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PremisecitationEarly anti-inflammatory intervention effectively prevents immune damage and reduces the risk of nervous system injury.
“while early anti-inflammatory intervention effectively prevent immune damage and reduce the risk of injury in the nervous system (Mehta et al., 2020, Fu et al., 2010).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Mehta et al., 2020
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- cites Fu et al., 2010
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PremisecitationLung virus proliferation causes alveolar/interstitial inflammation and edema, leading to CNS hypoxia and increased anaerobic metabolism in brain cells.
“When a virus proliferates in lung tissue cells, it causes diffuse alveolar and interstitial inflammatory exudation, edema, and the formation of transparent membranes. This, in turn, leads to alveolar gas exchange disorders causing hypoxia in the CNS, increasing anaerobic metabolism in the mitochondria of brain cells (Abdennour et al., 2012).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Abdennour et al., 2012 source
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Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
PremisecitationSARS and COVID-19 have resulted in a large number of fatalities, most due to multiple organ failure caused by virus-induced SIRS or SIRS-like immune disorders.
“Furthermore, SARS and COVID-19 have resulted in a large number of fatalities, most of which have been due to multiple organs failure (MOF) caused by virus-induced SIRS or SIRS-like immune disorders (Yin et al., 2004, Chen et al., 2020).”
Quote in the paperNot a substantial claim0 of 2 sources checked- cites Yin et al., 2004
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- cites Chen et al., 2020
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PremisecitationNerve cells lack major histocompatibility complex antigens, so elimination of viruses in nerve cells depends solely on cytotoxic T cells.
“Due to the lack of major histocompatibility complex antigens in nerve cells, the elimination of viruses in nerve cells depends solely on the role of cytotoxic T cells; however, the apoptosis of mature neurons after virus infection also has a relatively protective effect (Wuthrich et al., 2015).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wuthrich et al., 2015 source
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InterpretationcitationSARS-CoV-2 spike protein could interact with ACE2 expressed in the capillary endothelium, and the virus may damage the blood-brain barrier and enter the CNS by attacking the vascular system.
“In addition, given that SARS-CoV-2 spike protein could interact with ACE2 expressed in the capillary endothelium, the virus may also damage the blood–brain barrier and enter the CNS by attacking the vascular system (Baig et al., 2020).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Baig et al., 2020 source
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InterpretationreasoningBinding to ACE2 receptors, CoV and influenza viruses may cause abnormally elevated blood pressure and increase the risk of cerebral hemorrhage.
“Binding to ACE2 receptors, the above-mentioned viruses may cause abnormally elevated blood pressure and increase the risk of cerebral hemorrhage.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationA neurotropic virus can activate glial cells and induce a pro-inflammatory state.
“A neurotropic virus can activate glial cells and induce a pro-inflammatory state (Li et al., 2004).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Li et al., 2004
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The paper relies on this without support.
Findings from animal models (e.g., mice) about CoV neuroinvasion via the olfactory pathway apply to humans.
“However, removal of the olfactory bulb in the mice, resulted in a restricted invasion of CoV into the CNS (Bohmwald et al., 2018).”
The paper relies on this without support.
In vitro findings on glial cell cytokine secretion after CoV infection apply to human CNS immune injury.
“Additionally, experiments have confirmed that primary glial cells cultured in vitro secrete a large amount of inflammatory factors such as IL-6, IL-12, IL-15, and TNF-α after being infected with CoV (Bohmwald et al., 2018).”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
COVID-19 may affect other major body organs, including renal, cardiovascular, and central nervous systems.
“subsequent reports showed that COVID-19 may also affect other major body organs, including renal, cardiovascular, and central nervous systems (CNS) [16, 125, 128].”
From Cognitive decline following acute viral infections: literature review and projections for post-COVID-19 (2022) · cites this paper as [125]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Fu citation year conflicts with reference list
MinorThe text cites Fu et al. as a 2010 publication, but the corresponding reference lists it as published in 2020.
“(Mehta et al., 2020, Fu et al., 2010).”
“11. Fu, Y., Cheng, Y., Wu, Y., 2020.”
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Genome Composition and Divergence of the Novel Coronavirus (2019-nCoV) Originating in China
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- Authors
- Wu, Y., Xu, X., Chen, Z., Duan, J., Hashimoto, K., Yang, L., Liu, C., & Yang, C.
- Affiliations
- Soochow University (CN)
- Tongji Hospital (CN)
- Chiba University (JP)
- Jiangsu Province Hospital (CN)
- Corresponding author
- Yang, Ling
- Liu, Cunming
- Yang, Chun
- Venue
- Brain, Behavior, and Immunity
- Publisher
- Elsevier BV
- Published
- 2020-07
- Volume
- 87
- Pages
- 18-22
- ISSN
- 0889-1591 (ISSN-L)
- PMC
- PMC7146689
- OpenAlex
- W3013270768
- Semantic Scholar
- 6494984f43785e839a9b7b7f8ee8e9c2cb5148f2
- Cited by
- 2,046
- References
- 57
- Citations by year
- 2026: 18 · 2025: 52 · 2024: 124 · 2023: 214 · 2022: 359 · 2021: 628 · 2020: 646 · 2019: 1 · 2018: 1 · 2015: 1
- FWCI
- 51.86
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Brain Behavior and Immunity (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (81703482, 81974171)
- Changzhou Science and Technology Bureau (CE20195044)
- Topics
- Health Sciences › Medicine › Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- COVID-19 pandemic, SARS-CoV-2, coronavirus, neuroinflammation, neurological complications, neurotropism, cerebrospinal fluid, brain infection, pathobiology, neurodegeneration
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Olfaction Disorders, Consciousness Disorders, Dysgeusia, Encephalitis, Humans, Nervous System Diseases, Pneumonia, Viral, Polyneuropathies, Seizures, Coronavirus Infections, Encephalitis, Viral, Neurotoxicity Syndromes, Guillain-Barre Syndrome, Stroke, Coronavirus 229E, Human, Coronavirus OC43, Human, Severe Acute Respiratory Syndrome, Severe acute respiratory syndrome-related coronavirus, Pandemics, Coronavirus NL63, Human, Middle East Respiratory Syndrome Coronavirus
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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