Is the Collapse of the Respiratory Center in the Brain Responsible for Respiratory Breakdown in COVID-19 Patients?

ACS Chem Neurosci. 2020 May 20;11(10):1379-1381. doi: 10.1021/acschemneuro.0c00217. Epub 2020 Apr 29.


Following the identification of severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002 and Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, we are now again facing a global highly pathogenic novel coronavirus (SARS-CoV-2) epidemic. Although the lungs are one of the most critically affected organs, several other organs, including the brain may also get infected. Here, we have highlighted that SARS-CoV-2 might infect the central nervous system (CNS) through the olfactory bulb. From the olfactory bulb, SARS-CoV-2 may target the deeper parts of the brain including the thalamus and brainstem by trans-synaptic transfer described for many other viral diseases. Following this, the virus might infect the respiratory center of brain, which could be accountable for the respiratory breakdown of COVID-19 patients. Therefore, it is important to screen the COVID-19 patients for neurological symptoms as well as possibility of the collapse of the respiratory center in the brainstem should be investigated in depth.

Keywords: Brain; COVID-19; SARS-CoV-2; coronavirus; respiratory center.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Betacoronavirus / isolation & purification
  • Betacoronavirus / pathogenicity*
  • COVID-19
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / physiopathology*
  • Coronavirus Infections / virology*
  • Disease Models, Animal
  • Humans
  • Mice
  • Mice, Transgenic
  • Pandemics
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / physiopathology*
  • Pneumonia, Viral / virology*
  • Respiration Disorders / physiopathology
  • Respiration Disorders / virology*
  • Respiratory Center / physiopathology
  • Respiratory Center / virology*
  • SARS-CoV-2
  • Severe acute respiratory syndrome-related coronavirus / pathogenicity