Cytotoxic T lymphocytes could contribute in COVID-19-induced
passing anosmia

Several clinical reports have demonstrated a spectrum of neurological manifestations of COVID-19 patients with subsequent post-mortem neuropathological findings. The aim of the case description is to show spotty inflammatory lesions in the olfactory bulb, which could lead to passing anosmia. Microscopic examination showed severe ischaemia and microglial proliferation in the olfactory bulb region. We encountered the presence of perivascular infiltration of cytotoxic T lymphocytes (CD8). The COVID-19 pandemic brought us many new challenges concerning viral detection, transmission, abd spread, then clinical symptoms, and clinical outcome. It seems that cytotoxic T response could be a causative factor not only in respiratory tract injury but also is involved in the neural system, but further studies are required.

REFERENCES (13)

Pascarella G, Strumia A, Piliego C, Bruno F, Del Buono R, Costa F, Scarlata S, Agrò FE. COVID-19 diagnosis and management: a comprehensive review. J Intern Med 2020; 288: 192-206.

Google Scholar

Wu D, Wu T, Liu Q, Yang Z. The SARS-CoV-2 outbreak: what we know. Int J Infect Dis 2020; 94: 44-48.

Google Scholar

Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323: 1061-1069.

Google Scholar

Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, Chang J, Hong C, Zhou Y, Wang D, Miao X, Li Y, Hu B. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2020; 77: 683-690.

Google Scholar

Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. J Autoimmun 2020; 109: 102433.

Google Scholar

Wan Y, Shang J, Graham R, Baric RS, Li F. Receptor recognition by the novel coronavirus from Wuhan: an analysis based on decade-long structural studies of SARS coronavirus. J Virol 2020; 94: e00127-20.

Google Scholar

Doobay MF, Talman LS, Obr TD, Tian X, Davisson RL, Lazartigues E. Differential expression of neuronal ACE2 in transgenic mice with overexpression of the brain reninangiotensin system. Am J Physiol Regul Integr Comp Physiol 2007; 292: R373-R381.

Google Scholar

Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol 2008; 82: 7264-7275.

Google Scholar

Tsai LK, Hsieh ST, Chang YC. Neurological manifestations in severe acute respiratory syndrome. Acta Neurol Taiwan 2005; 14: 113-119.

Google Scholar

10.

Xu XW, Wu XX, Jiang XG, Xu KJ, Ying LJ, Ma CL, Li SB, Wang HY, Zhang S, Gao HN, Sheng JF, Cai HL, Qiu YQ, Li LJ. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ 2020; 368: m606.

Google Scholar

11.

Li Z, Liu T, Yang N, Han D, Mi X, Li Y, Liu K, Vuylsteke A, Xiang H, Guo X. Neurological manifestations of patients with COVID-19: potential routes of SARS-CoV-2 neuroinvasion from the periphery to the brain. Front Med 2020; 14: 533-541.

Google Scholar

12.

Vonck K, Garrez I, De Herdt V, Hemelsoet D, Laureys G, Raedt R, Boon P. Neurological manifestations and neuro-invasive mechanisms of the severe acute respiratory syndrome coronavirus type 2. Eur J Neurol 2020; 27: 1578-1587.

Google Scholar

13.

Fenrich M, Mrdenovic S, Balog M, Mrdenovic S, Balog M, Tomic S, Zjalic M, Roncevic A, Mandic D, Debeljak Z, Heffer M. SARS-CoV-2 dissemination through peripheral nerves explains multiple organ injury. Front Cell Neurosci 2020; 14: 229.

Google Scholar

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