4,464
Views
21
CrossRef citations to date
0
Altmetric
Clinical Features - Review

Potential neurological manifestations of COVID-19: a narrative review

ORCID Icon, ORCID Icon, ORCID Icon, ORCID Icon, ORCID Icon, ORCID Icon, ORCID Icon, , , , , & show all
Pages 395-405 | Received 17 Sep 2020, Accepted 13 Oct 2020, Published online: 11 Jan 2021

References

  • Di Carlo DT, Montemurro N, Petrella G, et al. Exploring the clinical association between neurological symptoms and COVID-19 pandemic outbreak: a systematic review of current literature. J Neurol. 2020;1–9.
  • Yu F, Du L, Ojcius DM, et al. Measures for diagnosing and treating infections by a novel coronavirus responsible for a pneumonia outbreak originating in Wuhan, China. Microbes Infect. 2020;22(2):74–79.
  • Song Z, Xu Y, Bao L, et al. From SARS to MERS, thrusting coronaviruses into the spotlight. Viruses. 2019;11(1):1.
  • Li Y-C, Bai W-Z, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020;92(6):552–555.
  • Yuan Y, Cao D, Zhang Y, et al. Cryo-EM structures of MERS-CoV and SARS-CoV spike glycoproteins reveal the dynamic receptor binding domains. Nat Commun. 2017;8(1):15092.
  • Hulswit RJ, de Haan CA, Bosch BJ. Coronavirus spike protein and tropism changes. Adv Virus Res. 2016;96:29–57.
  • Lai SL, Hsu MT, Chen SS. The impact of SARS on epilepsy: the experience of drug withdrawal in epileptic patients. Seizure. 2005;14(8):557–561.
  • Lippi A, Domingues R, Setz C, et al. SARS-CoV-2: at the crossroad between aging and neurodegeneration. Mov Disord. 2020;35(5):716–720.
  • Joob B, Wiwanitkit V. Neurologic syndrome due to MERS: is there a possibility that the virus can cross the blood-brain barrier to cause a neurological problem? Ann Trop Med Public Health. 2015;8(5):231.
  • Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. Jama. 2020;323(11):1061.
  • Field H. Bats and emerging zoonoses: henipavirus and SARS. Zoonoses. Public Health. 2009;56:278–284.
  • Bale JF Jr. Emerging viral infections. Semin Pediatr Neurol. 2012;19(3):152–157.
  • Pfefferle S, Oppong S, Drexler JF, et al. Distant relatives of severe acute respiratory syndrome coronavirus and close relatives of human coronavirus 229E in bats, Ghana. Emerg Infect Dis. 2009;15(9):1377–1384.
  • Williams S A brief history of human coronaviruses. The Scientist. The Scientist Web site. Published 2020 [cited 2020 Oct 12]. https://www.the-scientist.com/news-opinion/a-brief-history-of-human-coronaviruses-67600
  • Algahtani H, Subahi A, Shirah B. Neurological complications of middle east respiratory syndrome coronavirus: a report of two cases and review of the literature. Case Rep Neurol Med. 2016;2016:3502683.
  • Ghannam M, Alshaer Q, Al-Chalabi M, et al. Neurological involvement of coronavirus disease 2019: a systematic review. J Neurol. 2020;267(11):3135-3153.
  • Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565–574.
  • Wan Y, Shang J, Graham R, et al. Receptor recognition by novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS. J Virol. 2020;94(7). DOI:10.1128/JVI.00127-20
  • Walls AC, Park Y-J, Tortorici MA, et al. Structure, function, and antigenicity of the SARS-CoV-2 spike glycoprotein. Cell. 2020;181(2):281–292.e286.
  • Qing E, Hantak MP, Galpalli GG, et al. Evaluating MERS-CoV entry pathways. Methods Mol Biol. 2020;2099:9–20.
  • Carod-Artal FJ. Neurological complications of coronavirus and COVID-19. Rev Neurol. 2020;70(9):311–322.
  • Papa SM, Brundin P, Fung VSC, et al. Impact of the COVID-19 pandemic on Parkinson’s disease and movement disorders. Mov Disord. 2020;35(5):711-715.
  • Matsuda K, Park CH, Sunden Y, et al. The vagus nerve is one route of transneural invasion for intranasally inoculated influenza a virus in mice. Vet Pathol. 2004;41(2):101–107.
  • Nicholson TW, Talbot NP, Nickol A, et al. Respiratory failure and non-invasive respiratory support during the covid-19 pandemic: an update for re-deployed hospital doctors and primary care physicians. BMJ (Clin Res Ed). 2020;369:m2446.
  • Turtle L. Respiratory failure alone does not suggest central nervous system invasion by SARS-CoV-2. J Med Virol. 2020;92(7):705–706.
  • Griffin DE. Immune responses to RNA-virus infections of the CNS. Nat Rev Immunol. 2003;3(6):493–502.
  • Miner JJ, Diamond MS. Mechanisms of restriction of viral neuroinvasion at the blood-brain barrier. Curr Opin Immunol. 2016;38:18–23.
  • Desforges M, Le Coupanec A, Brison E, et al. Neuroinvasive and neurotropic human respiratory coronaviruses: potential neurovirulent agents in humans. Adv Exp Med Biol. 2014;807:75–96.
  • Partinen M, Kornum BR, Plazzi G, et al. Narcolepsy as an autoimmune disease: the role of H1N1 infection and vaccination. Lancet Neurol. 2014;13(6):600–613.
  • Najjar S, Najjar A, Chong DJ, et al. Central nervous system complications associated with SARS-CoV-2 infection: integrative concepts of pathophysiology and case reports. J Neuroinflammation. 2020;17(1):231.
  • Zaki AM, van Boheemen S, Bestebroer TM, et al. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med. 2012;367(19):1814–1820.
  • Kim CJ, Choi WS, Jung Y, et al. Surveillance of the Middle East respiratory syndrome (MERS) coronavirus (CoV) infection in healthcare workers after contact with confirmed MERS patients: incidence and risk factors of MERS-CoV seropositivity. Clin Microbiol Infect. 2016;22(10):880–886.
  • Kim JE, Heo JH, Kim HO, et al. Neurological complications during treatment of middle east respiratory syndrome. J Clin Neurol. 2017;13(3):227–233.
  • Saad M, Omrani AS, Baig K, et al. Clinical aspects and outcomes of 70 patients with Middle East respiratory syndrome coronavirus infection: a single-center experience in Saudi Arabia. Int J Infect Dis. 2014;29:301–306.
  • Tsai LK, Hsieh ST, Chang YC. Neurological manifestations in severe acute respiratory syndrome. Acta Neurol Taiwan. 2005;14(3):113–119.
  • Arbour N, Ekande S, Cote G, et al. Persistent infection of human oligodendrocytic and neuroglial cell lines by human coronavirus 229E. J Virol. 1999;73(4):3326–3337.
  • Gu J, Gong E, Zhang B, et al. Multiple organ infection and the pathogenesis of SARS. J Exp Med. 2005;202(3):415–424.
  • Ding Y, Wang H, Shen H, et al. The clinical pathology of severe acute respiratory syndrome (SARS): a report from China. J Pathol. 2003;200(3):282–289.
  • Xu J, Zhong S, Liu J, et al. Detection of severe acute respiratory syndrome coronavirus in the brain: potential role of the chemokine mig in pathogenesis. Clin Infect Dis. 2005;41(8):1089–1096.
  • Netland J, Meyerholz DK, Moore S, et al. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol. 2008;82(15):7264–7275.
  • Li K, Wohlford-Lenane C, Perlman S, et al. Middle East respiratory syndrome coronavirus causes multiple organ damage and lethal disease in mice transgenic for human dipeptidyl peptidase 4. J Infect Dis. 2016;213(5):712–722.
  • McCray PB Jr., Pewe L, Wohlford-Lenane C, et al. Lethal infection of K18-hACE2 mice infected with severe acute respiratory syndrome coronavirus. J Virol. 2007;81(2):813–821.
  • Hwang CS. Olfactory neuropathy in severe acute respiratory syndrome: report of A case. Acta Neurol Taiwan. 2006;15(1):26–28.
  • Chao CC, Tsai LK, Chiou YH, et al. Peripheral nerve disease in SARS:: report of a case. Neurology. 2003;61(12):1820–1821.
  • Hung EC, Chim SS, Chan PK, et al. Detection of SARS coronavirus RNA in the cerebrospinal fluid of a patient with severe acute respiratory syndrome. Clin Chem. 2003;49(12):2108–2109.
  • Lau KK, Yu WC, Chu CM, et al. Possible central nervous system infection by SARS coronavirus. Emerg Infect Dis. 2004;10(2):342–344.
  • Tsai LK, Hsieh ST, Chao CC, et al. Neuromuscular disorders in severe acute respiratory syndrome. Arch Neurol. 2004;61(11):1669–1673.
  • Fitzgerald S. The spread of COVID-19: questions raised, some answered by neuroinfectious disease experts. Neurol Today. 2020;20(7):1,25–26.
  • Jin H, Hong X, Chen S, et al. Consensus for prevention and management of coronavirus disease 2019 (COVID-19) for neurologists. Stroke Vasc Neurol. 2020;5(2):146–151.
  • Abboud H, Abboud FZ, Kharbouch H, et al. COVID-19 and SARS-Cov-2 infection: pathophysiology and clinical effects on the nervous system. World Neurosurg. 2020;140:49–53.
  • Asadi-Pooya AA, Simani L. Central nervous system manifestations of COVID-19: A systematic review. J Neurol Sci. 2020;413:116832.
  • Mao L, Wang M, Chen S, et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. medRxiv. 2020;77(6):683-690.
  • Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020;277(8):2251–2261.
  • Printza A, Constantinidis J. The role of self-reported smell and taste disorders in suspected COVID‑19. Eur Arch Otorhinolaryngol. 2020;277(9):2625–2630.
  • Tong JY, Wong A, Zhu D, et al. The prevalence of olfactory and gustatory dysfunction in COVID-19 patients: a systematic review and meta-analysis. Otolaryngol Head Neck Surg. 2020;163(1):3–11.
  • Moriguchi T, Harii N, Goto J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. 2020;94:55–58.
  • Hanna Huang Y, Jiang D, Huang JT. A case of COVID-19 encephalitis. Brain Behav Immun. 2020;87:149.
  • To KF, Lo AW. Exploring the pathogenesis of severe acute respiratory syndrome (SARS): the tissue distribution of the coronavirus (SARS-CoV) and its putative receptor, angiotensin-converting enzyme 2 (ACE2). J Pathol. 2004;203(3):740–743.
  • Tang JW, To KF, Lo AW, et al. Quantitative temporal-spatial distribution of severe acute respiratory syndrome-associated coronavirus (SARS-CoV) in post-mortem tissues. J Med Virol. 2007;79(9):1245–1253.
  • Kam YW, Okumura Y, Kido H, et al. Cleavage of the SARS coronavirus spike glycoprotein by airway proteases enhances virus entry into human bronchial epithelial cells in vitro. PLoS One. 2009;4(11):e7870.
  • Donoghue M, Hsieh F, Baronas E, et al. A novel angiotensin-converting enzyme-related carboxypeptidase (ACE2) converts angiotensin I to angiotensin 1-9. Circ Res. 2000;87(5):E1–9.
  • Hamming I, Timens W, Bulthuis M, et al. Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004;203(2):631–637.
  • Boonacker E, Van Noorden CJ. The multifunctional or moonlighting protein CD26/DPPIV. Eur J Cell Biol. 2003;82(2):53–73.
  • Bernstein HG, Dobrowolny H, Keilhoff G, et al. Dipeptidyl peptidase IV, which probably plays important roles in Alzheimer disease (AD) pathology, is upregulated in AD brain neurons and associates with amyloid plaques. Neurochem Int. 2018;114:55–57.
  • Li YC, Bai WZ, Hirano N, et al. Coronavirus infection of rat dorsal root ganglia: ultrastructural characterization of viral replication, transfer, and the early response of satellite cells. Virus Res. 2012;163(2):628–635.
  • Li YC, Bai WZ, Hirano N, et al. Neurotropic virus tracing suggests a membranous-coating-mediated mechanism for transsynaptic communication. J Comp Neurol. 2013;521(1):203–212.
  • Andries K, Pensaert MB. Immunofluorescence studies on the pathogenesis of hemagglutinating encephalomyelitis virus infection in pigs after oronasal inoculation. Am J Vet Res. 1980;41(9):1372–1378.
  • Mengeling WL, Boothe AD, Ritchie AE. Characteristics of a coronavirus (strain 67N) of pigs. Am J Vet Res. 1972;33(2):297–308.
  • Khan S, Ali A, Siddique R, et al. Novel coronavirus is putting the whole world on alert. J Hosp Infect. 2020;104(3):252–253.
  • Guidon AC, Amato AA. COVID-19 and neuromuscular disorders. Neurology. 2020;94(22):959–969.
  • Paterson RW, Brown RL, Benjamin L, et al. The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings. Brain. 2020. DOI:10.1093/brain/awaa240
  • Varatharaj A, Thomas N, Ellul MA, et al. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study. Lancet Psychiatry. 2020;7(10):875–882.
  • Romero-Sánchez CM, Díaz-Maroto I, Fernández-Díaz E, et al. Neurologic manifestations in hospitalized patients with COVID-19: the ALBACOVID registry. Neurology. 2020;95(8):e1060-e1070.
  • Filatov A, Sharma P, Hindi F, et al. Neurological complications of coronavirus disease (COVID-19): encephalopathy. Cureus. 2020;12(3):e7352.
  • Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8(4):420–422.
  • Guan W-J, Ni Z-Y, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708–1720.
  • Kotfis K, Williams Roberson S, Wilson JE, et al. COVID-19: ICU delirium management during SARS-CoV-2 pandemic. Crit Care. 2020;24(1):176.
  • A SPECIAL MEETING REVIEW EDITION: Highlights in Crohn’s Disease and Ulcerative Colitis: Digestive Disease Week 2012 May 19-22. 2012 * San Diego, CaliforniaSpecial Reporting on:* Safety and efficacy of subcutaneous golimumab induction therapy in patients with moderately to severely active UC: PURSUIT-SC* The future of IBD therapy: individualized and optimized therapy and novel mechanisms* Infliximab concentration and clinical outcome in patients with UC* Vedolizumab induction therapy for UC: results of GEMINI I, a randomized, placebo-controlled, double-blind, multicenter, phase III trial* novel infliximab and antibody-to-infliximab assays are predictive of disease activity in patients with CD* accelerated step-care therapy with early azathioprine versus conventional step-care therapy in CD* PIANO: a 1,000-patient prospective registry of pregnancy outcomes in women with IBD exposed to immunomodulators and biologic TherapyPLUS meeting abstract summaries with expert commentary by: William J. Sandborn, MD chief of the Division of Gastroenterology Director of the UCSD IBD Center UC San Diego Health System La Jolla, California. Gastroenterol Hepatol. 2012;8(8 Suppl 5):1–24.
  • Han JH, Zimmerman EE, Cutler N, et al. Delirium in older emergency department patients: recognition, risk factors, and psychomotor subtypes. Acad Emerg Med. 2009;16(3):193–200.
  • Francis J, Martin D, Kapoor WN. A prospective study of delirium in hospitalized elderly. Jama. 1990;263(8):1097–1101.
  • Elie M, Rousseau F, Cole M, et al. Prevalence and detection of delirium in elderly emergency department patients. Cmaj. 2000;163(8):977–981.
  • Spronk PE, Riekerk B, Hofhuis J, et al. Occurrence of delirium is severely underestimated in the ICU during daily care. Intensive Care Med. 2009;35(7):1276–1280.
  • Beach SR, Praschan NC, Hogan C, et al. Delirium in COVID-19: A case series and exploration of potential mechanisms for central nervous system involvement. Gen Hosp Psychiatry. 2020;65:47–53.
  • Werner C, Scullen T, Mathkour M, et al. Neurological impact of coronavirus disease (COVID-19): practical considerations for the neuroscience community. World Neurosurg. 2020;139:344–354.
  • Poyiadji N, Shahin G, Noujaim D, et al. COVID-19-associated acute hemorrhagic necrotizing encephalopathy: CT and MRI features. Radiology. 2020;296(2):E119-E120.
  • Ely EW, Gautam S, Margolin R, et al. The impact of delirium in the intensive care unit on hospital length of stay. Intensive Care Med. 2001;27(12):1892–1900.
  • Ely EW, Shintani A, Truman B, et al. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. Jama. 2004;291(14):1753–1762.
  • Pandharipande PP, Girard TD, Jackson JC, et al. Long-term cognitive impairment after critical illness. N Engl J Med. 2013;369(14):1306–1316.
  • Abdel-Mannan O, Eyre M, Löbel U, et al. Neurologic and radiographic findings associated with COVID-19 infection in children. JAMA Neurol. 2020. DOI:10.1001/jamaneurol.2020.2687
  • Cao-Lormeau VM, Blake A, Mons S, et al. Guillain-Barre syndrome outbreak associated with Zika virus infection in French Polynesia: a case-control study. Lancet. 2016;387(10027):1531–1539.
  • Abrams RMC, Kim BD, Markantone DM, et al. Severe rapidly progressive Guillain-Barré syndrome in the setting of acute COVID-19 disease. J Neurovirol. 2020; 26(5):797-799.
  • Toscano G, Palmerini F, Ravaglia S, et al. Guillain-Barré syndrome associated with SARS-CoV-2. N Engl J Med. 2020;382(26):2574–2576.
  • Arnaud S, Budowski C, Ng Wing Tin S, et al. Post SARS-CoV-2 Guillain-Barré syndrome. Clin Neurophysiol. 2020;131(7):1652–1654.
  • Scheidl E, Canseco DD, Hadji-Naumov A, et al. Guillain-Barré syndrome during SARS-CoV-2 pandemic: A case report and review of recent literature. J Peripher Nerv Syst. 2020;25(2):204–207.
  • Zhao H, Shen D, Zhou H, et al. Guillain-Barre syndrome associated with SARS-CoV-2 infection: causality or coincidence? Lancet Neurol. 2020;19(5):383–384.
  • Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395(10223):497–506.
  • Wang JT, Sheng WH, Fang CT, et al. Clinical manifestations, laboratory findings, and treatment outcomes of SARS patients. Emerg Infect Dis. 2004;10(5):818–824.
  • Chen LL, Hsu CW, Tian YC, et al. Rhabdomyolysis associated with acute renal failure in patients with severe acute respiratory syndrome. Int J Clin Pract. 2005;59(10):1162–1166.
  • Ye M, Ren Y, Lv T. Encephalitis as a clinical manifestation of COVID-19. Brain Behav Immun. 2020;88:945–946.
  • Leitinger M, Beniczky S, Rohracher A, et al. Salzburg consensus criteria for non-convulsive status epilepticus–approach to clinical application. Epilepsy Behav. 2015;49:158–163.
  • Baker AM, Yasavolian MA, Arandi NR. Nonconvulsive status epilepticus: overlooked and undertreated. Emerg Med Pract. 2019;21(10):1–24.
  • Trinka E, Leitinger M. Which EEG patterns in coma are nonconvulsive status epilepticus? Epilepsy Behav. 2015;49:203–222.
  • Román GC, Spencer PS, Reis J, et al. The neurology of COVID-19 revisited: A proposal from the environmental neurology specialty group of the world federation of neurology to implement international neurological registries. J Neurol Sci. 2020;414:116884.
  • Bolay H, Gül A, Baykan B. COVID-19 is a real headache! Headache. 2020;60(7):1415–1421.
  • Bobker SM, Robbins MS. COVID-19 and headache: A primer for trainees. Headache. 2020;60(8):1806–1811.
  • Zifko UA, Zipko HT, Bolton CF. Clinical and electrophysiological findings in critical illness polyneuropathy. J Neurol Sci. 1998;159(2):186–193.
  • Bolton CF. Sepsis and the systemic inflammatory response syndrome: neuromuscular manifestations. Crit Care Med. 1996;24(8):1408–1416.
  • Li Y, Wang M, Zou Y, et al. Acute cerebrovascular disease following COVID-19: a single, retrospective, observational study. Stroke Vasc Neurol 2020;5(3):279-284.
  • Duvoisin RC, Yahr MD. Encephalitis and parkinsonism. Arch Neurol. 1965;12(3):227–239.
  • Fazzini E, Fleming J, Fahn S. Cerebrospinal fluid antibodies to coronavirus in patients with Parkinson’s disease. Mov Disord. 1992;7(2):153–158.
  • Wong GF, Gray CS, Hassanein RS, et al. Environmental risk factors in siblings with Parkinson’s disease. Arch Neurol. 1991;48(3):287–289.
  • Koller W, Vetere-Overfield B, Gray C, et al. Environmental risk factors in Parkinson’s disease. Neurology. 1990;40(8):1218–1221.
  • Prasad S, Holla VV, Neeraja K, et al. Parkinson’s disease and COVID-19: perceptions and implications in patients and caregivers. Mov Disord. 2020;35(6):912–914.
  • Helmich RC, Bloem BR. The impact of the COVID-19 pandemic on Parkinson’s disease: hidden sorrows and emerging opportunities. J Parkinsons Dis. 2020;10(2):351–354.
  • Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020;92(6):552-555.
  • Baig AM, Khaleeq A, Ali U, et al. Evidence of the COVID-19 virus targeting the CNS: tissue distribution, host-virus interaction, and proposed neurotropic mechanisms. ACS Chem Neurosci. 2020;11(7):995–998.
  • Baig AM. Neurological manifestations in COVID-19 caused by SARS-CoV-2. CNS Neurosci Ther. 2020;26(5):499–501.
  • Swanson PA 2nd, McGavern DB. Viral diseases of the central nervous system. Curr Opin Virol. 2015;11:44–54.
  • Zhang W, Zhao Y, Zhang F, et al. The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): the perspectives of clinical immunologists from China. Clin Immunol. 2020;214:108393.
  • Sanders JM, Monogue ML, Jodlowski TZ, et al. Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review. Jama. 2020. DOI:10.1001/jama.2020.6019
  • Needham EJ, Chou SH, Coles AJ, et al. Neurological implications of COVID-19 infections. Neurocrit Care. 2020;32(3):667–671.
  • Sheehy LM. Considerations for postacute rehabilitation for survivors of COVID-19. JMIR Public Health Surveill. 2020;6(2):e19462–e19462.
  • Tramonti F, Bonfiglio L, Bongioanni P, et al. Caregiver burden and family functioning in different neurological diseases. Psychol Health Med. 2019;24(1):27–34.
  • Whiteford HA, Ferrari AJ, Degenhardt L, et al. The global burden of mental, neurological and substance use disorders: an analysis from the global burden of disease study 2010. PLoS One. 2015;10(2):e0116820.
  • Ding Y, He L, Zhang Q, et al. Organ distribution of severe acute respiratory syndrome (SARS) associated coronavirus (SARS-CoV) in SARS patients: implications for pathogenesis and virus transmission pathways. J Pathol. 2004;203(2):622–630.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.