The potential role of microvascular pathology in the neurological manifestations of coronavirus infection

M. A. MacLean, L. Kamintsky, E. D. Leck, A. Friedman

Research output: Contribution to journalReview articlepeer-review

11 Scopus citations


Human coronaviruses are highly pathogenic viruses that pose a serious threat to human health. Examples include the severe acute respiratory syndrome outbreak of 2003 (SARS-CoV-1), the Middle East Respiratory Syndrome (MERS-CoV) outbreak of 2012, and the current SARS-CoV-2 (COVID-19) pandemic. Herein, we review the neurological manifestations of coronaviruses and discuss the potential pathogenic role of blood-brain barrier dysfunction. We present the hypothesis that pre-existing vascular damage (due to aging, cardiovascular disease, diabetes, hypertension or other conditions) facilitates infiltration of the virus into the central nervous system (CNS), increasing neuro-inflammation and the likelihood of neurological symptoms. We also discuss the role of a neuroinflammatory cytokine profile in both blood-brain barrier dysfunction and macrovascular disease (e.g. ischemic stroke and thromboembolism). Future studies are needed to better understand the involvement of the microvasculature in coronavirus neuropathology, and to test the diagnostic potential of minimally-invasive screening tools (e.g. serum biomarkers, fluorescein retinal angiography and dynamic-contrast MRI).

Original languageEnglish
Article number55
JournalFluids and Barriers of the CNS
Issue number1
StatePublished - 10 Sep 2020
Externally publishedYes


  • Blood-brain barrier
  • Coronavirus
  • Neurological
  • Neurology
  • SARS-CoV-2
  • Stroke

ASJC Scopus subject areas

  • Neurology
  • Developmental Neuroscience
  • Cellular and Molecular Neuroscience


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