德国柏林洪堡大学Frank L. Heppner研究组发现SARS-CoV-2利用鼻腔感染中枢神经系统（CNS）的证据。相关论文于2020年11月30日在线发表在《自然—神经科学》杂志上。

通过各种方式，研究人员证明了鼻咽和大脑在解剖学上不同的区域中存在SARS-CoV-2 RNA和蛋白质。此外，研究人员描述了与感染相关的形态变化，例如中枢神经系统的血栓栓塞性缺血梗死，并提供了SARS-CoV-2神经嗜性的证据。SARS-CoV-2可以通过嗅觉粘膜中的神经-粘膜界面，利用嗅觉粘膜、内皮和神经组织（包括脆弱的嗅觉和感觉神经末梢）的近处进入神经系统。随后，SARS-CoV-2似乎依靠神经解剖结构来穿透特定的神经解剖区域，包括延髓中的主要呼吸和心血管控制中心。

据了解，新发现的SARS-CoV-2导致了大流行性呼吸道疾病COVID-19。此外，人们已经报道了包括CNS在内的全身性血栓栓塞事件。考虑到在大多数COVID-19个体中观察到的神经系统症状，中枢神经系统可能会出现SARS-CoV-2感染。

附：英文原文

Title: Olfactory transmucosal SARS-CoV-2 invasion as a port of central nervous system entry in individuals with COVID-19

Author: Jenny Meinhardt, Josefine Radke, Carsten Dittmayer, Jonas Franz, Carolina Thomas, Ronja Mothes, Michael Laue, Julia Schneider, Sebastian Brnink, Selina Greuel, Malte Lehmann, Olga Hassan, Tom Aschman, Elisa Schumann, Robert Lorenz Chua, Christian Conrad, Roland Eils, Werner Stenzel, Marc Windgassen, Larissa Rler, Hans-Hilmar Goebel, Hans R. Gelderblom, Hubert Martin, Andreas Nitsche, Walter J. Schulz-Schaeffer, Samy Hakroush, Martin S. Winkler, Bjrn Tampe, Franziska Scheibe, Pter Krtvlyessy, Dirk Reinhold, Britta Siegmund, Anja A. Khl, Sefer Elezkurtaj, David Horst, Lars Oesterhelweg, Michael Tsokos, Barbara Ingold-Heppner, Christine Stadelmann, Christian Drosten, Victor Max Corman, Helena Radbruch, Frank L. Heppner

Issue&Volume: 2020-11-30

Abstract: The newly identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, a pandemic respiratory disease. Moreover, thromboembolic events throughout the body, including in the CNS, have been described. Given the neurological symptoms observed in a large majority of individuals with COVID-19, SARS-CoV-2 penetrance of the CNS is likely. By various means, we demonstrate the presence of SARS-CoV-2 RNA and protein in anatomically distinct regions of the nasopharynx and brain. Furthermore, we describe the morphological changes associated with infection such as thromboembolic ischemic infarction of the CNS and present evidence of SARS-CoV-2 neurotropism. SARS-CoV-2 can enter the nervous system by crossing the neural–mucosal interface in olfactory mucosa, exploiting the close vicinity of olfactory mucosal, endothelial and nervous tissue, including delicate olfactory and sensory nerve endings. Subsequently, SARS-CoV-2 appears to follow neuroanatomical structures, penetrating defined neuroanatomical areas including the primary respiratory and cardiovascular control center in the medulla oblongata.

DOI: 10.1038/s41593-020-00758-5

Source: https://www.nature.com/articles/s41593-020-00758-5