Table 2.

Potential mechanisms of coronavirus neuropathogenesis

Infection of olfactory neuroepithelium with transaxonal spread into deeper brain regions

Infection of brain vasculature:

Direct spread from endothelia/vascular structures into neurons and glia

Vascular occlusion or inflammation/vasculitis with ischemia/hemorrhage

Infection of lymphocytes and monocytes/macrophages:

Migration across blood–brain and blood–CSF barrier with immune-mediated damage

Migration across blood–brain and blood–CSF barrier with spreading viral infection

Para-infectious sequelae:

Increased thrombophilia with cerebral infarction

Dysregulated immunity with cerebral demyelination or necrosis

Febrile seizures