SARS-CoV-2: Olfaction, Brain Infection, and the Urgent Need for Clinical Samples Allowing Earlier Virus Detection
Open accessAbstract
The novel SARS-CoV-2 virus has very high infectivity, which allows it to spread rapidly around the world. Attempts at slowing the pandemic at this stage depend on the number and quality of diagnostic tests performed. We propose that the olfactory epithelium from the nasal cavity may be a more appropriate tissue for detection of SARS-CoV-2 virus at the earliest stages, prior to onset of symptoms or even in asymptomatic people, as compared to commonly used sputum or nasopharyngeal swabs. Here we emphasize that the nasal cavity olfactory epithelium is the likely site of enhanced binding of SARS-CoV-2. Multiple non-neuronal cell types present in the olfactory epithelium express two host receptors, ACE2 and TMPRSS2 proteases, that facilitate SARS-CoV-2 binding, replication, and accumulation. This may be the underlying mechanism for the recently reported cases of smell dysfunction in patients with COVID-19. Moreover, the possibility of subsequent brain infection should be considered which begins in olfactory neurons. In addition, we discuss the possibility that olfactory receptor neurons may initiate rapid immune responses at early stages of the disease. We emphasize the need to undertake research focused on additional aspects of SARS-CoV-2 actions in the nervous system, especially in the olfactory pathway.
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Reported impaired olfaction could be due to CNS invasion or direct damage of olfactory sensory neurons in the nasal cavity.
“Moreover, reported impaired olfaction could be due to CNS invasion or direct damage of olfactory sensory neurons in the nasal cavity [24].”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [24]
SARS-CoV, MERS-CoV, and HCoV-OCR43 were able to invade the murine CNS using the transcribrial route, infecting olfactory sensory neurons of the nasal cavity and passing to other neural cells, indicating that SARS-CoV-2 could use the same mechanism.
“In fact, SARS-CoV, MERS-CoV, and HCoV-OCR43 were able to invade the murine CNS using the transcribrial route, infecting olfactory sensory neurons of nasal cavity, and passing to other neural cells, indicating that SARS-CoV-2 could use the same mechanism [24, 35–37].”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [24]
COVID-19 patients are suffering acute cerebrovascular disorder and other correlated neurological symptoms as consequences of stroke or micro-strokes.
“COVID-19 patients are suffering acute cerebrovascular disorder and other correlated neurological symptoms as consequences of stroke or micro-strokes [24].”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [24]
Klok and colleagues observed disturbing increases in the incidence of thrombotic complications in critically ill intensive care unit patients as high as 31% and recommended pharmacological prophylaxis against thrombosis.
“Klok and colleagues observed disturbing increases in the incidence of thrombotic complications in critically ill intensive care unit patients as high as 31% and recommended pharmacological prophylaxis against thrombosis [24].”
From Hyperactivation of P2X7 receptors as a culprit of COVID-19 neuropathology (2021) · cites this paper as [24]
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- Authors
- Butowt, R., & Bilinska, K.
- Affiliations
- L. Rydygier Collegium Medicum, Nicolaus Copernicus University, Ul. CurieSklodowskiej 9, 85-94 Bydgoszcz, Poland
- Venue
- ACS Chemical Neuroscience
- Publisher
- American Chemical Society (ACS)
- Published
- 2020-04-13
- Volume
- 11
- Issue
- 9
- Pages
- 1200-1203
- ISSN
- 1948-7193 (ISSN-L)
- OpenAlex
- W3015599845
- Cited by
- 346
- References
- 10
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 10 · 2023: 32 · 2022: 56 · 2021: 111 · 2020: 124 · 2019: 1
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- ACS Chemical Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Polish National Science Center (UMO-2013/09/B/NZ3/02359)
- Topics
- Life Sciences › Neuroscience › Sensory Systems › Olfactory and Sensory Function Studies
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 detection and testing
- Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
- Keywords
- SARS-CoV-2, COVID-19 pandemic, olfactory epithelium, olfactory sensory neurons, virus detection, asymptomatic infection, ACE2, TMPRSS2, olfactory dysfunction, brain infection, olfactory pathway, nasal cavity, diagnostic sampling, immune response
- MeSH terms
- Betacoronavirus, Angiotensin-Converting Enzyme 2, COVID-19, SARS-CoV-2, Animals, Brain, Humans, Immunity, Innate, Peptidyl-Dipeptidase A, Mass Screening, Olfactory Mucosa, Pneumonia, Viral, Serine Endopeptidases, Smell, Virus Replication, Olfactory Receptor Neurons, Coronavirus Infections, Respiratory Mucosa, Early Diagnosis, Mice, Pandemics
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