This is a very nice question. Thank you for asking that. So, one thing that we know based on the experience observed in China, in Italy, in Europe, and right now in the United States is coronavirus, this novel coronavirus is not a neurotropic virus or neurovirulent virus. What is the meaning of that? Neurotropic means a virus that is going to target specifically the brain, the spinal cord, or a structure of the nervous system. This [corona]virus is behaving in a different way. This virus is not neurotropic. This virus is not neurovirulent. In other words, this virus is not producing a major impact in the central nervous system because the virus is invading the central nervous system or spinal cord or optic nerve or brain. This virus doesn’t have that property. It may happen readily, extremely readily, but those are very different situations and circumstances, particularly because the patient is extremely immunosuppressed and may have neurological consequences after that.
However, that is very well known, at least up to now, is that this is not a neurotropic virus. So that means that the neurological consequences of the coronavirus infection at this moment are mostly secondary. So in other words, the damage of the lungs, the damage of the blood vessels, the damage of the heart, eventually may produce secondary neurological effects. The complications associated with coronavirus and the brain or the spinal cord or the peripheral nervous system are mostly associated with secondary complications.
For example, there has been an increase in the effect of strokes. In other words, patients who are susceptible to strokes get coronavirus infection, those patients actually increase the risk of strokes because the cardiovascular situation, the pulmonary situations. It has been noted, for example, that patients with coronavirus infections develop more brain disfunction, secondary to the lack of oxygenation. So that is mostly a secondary effect, but that doesn’t mean that the virus is damaging directly the brain, the spinal cord or peripheral nerves. There are very few case reports, mostly anecdotal reports, of some very rare neurological complications like Guillain-Barré syndrome that is a neurological disorder in which there is an autoimmune damage of the peripheral nerves that eventually may lead to paralysis. There is only one report up to now of a patient suspected to have that situation. But again, in millions of people that have been exposed to coronavirus already in the world, there are extremely, extremely rare descriptions of neurological complications.