Thread by @EricTopol

Does #SARSCoV2 directly infect @brain cells?
A brief review of the evidence
1. An exhaustive @TheLancetNeuro clinical review suggested this but w/ little supportive data thelancet.com/journals/laneu…

2. The mechanism for loss of smell has invoked both direct viral invasion of the olfactory bulb and indirect effects
Direct jamanetwork.com/journals/jamao… @JAMAOto
Indirect
advances.sciencemag.org @ScienceAdvances

3. A very recent, in-depth review of the pathogenesis of #SARSCoV2 and the nervous system concluded the evidence is inconsistent
cell.com/cell/retrieve/… @CellCellPress

4. A preprint this week by @YaleMed @YaleIBIO @ericsongg @VirusesImmunity looked at this question in 3 ways: autopsy of brain tissue positive for virus, organoids, and a mouse model, all quite supportive of direct infections biorxiv.org/content/10.110…

5. The invasive potential of #SARSCoV2 to infect brain cells could be elucidated in the organoid or mouse model, whereby antibodies to ACE2 or CSF from a #COVID19 patient inhibited, and overexpressed hACE2 mice facilitated

6. The important study was summarized and translated by @apoorva_nyc @NYTScience
nytimes.com/2020/09/09/hea…

7/f. I think the evidence now exists for direct brain cell invasion by this virus. Beyond that, the indirect effects to the CNS via immune response and mediators, ischemia, thrombosis are well documented.