{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:29:36Z","timestamp":1791221376357,"version":"4.1.0"},"reference-count":194,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T00:00:00Z","timestamp":1650585600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000156","name":"Fonds de Recherche du Qu\u00e9bec - Sant\u00e9","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000156","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>While the respiratory tract is the primary route of entry for SARS-CoV-2, evidence shows that the virus also impacts the central nervous system. Intriguingly, case reports have documented SARS-CoV-2 patients presenting with demyelinating lesions in the brain, spinal cord, and optic nerve, suggesting possible implications in neuroimmune disorders such as multiple sclerosis (MS) and other related neuroimmune disorders. However, the cellular mechanisms underpinning these observations remain poorly defined. The goal of this paper was to review the literature to date regarding possible links between SARS-CoV-2 infection and neuroimmune demyelinating diseases such as MS and its related disorders, with the aim of positing a hypothesis for disease exacerbation. The literature suggests that SARS-CoV, SARS-CoV-2, and orthologous murine coronaviruses invade the CNS<jats:italic>via<\/jats:italic>the olfactory bulb, spreading to connected structures<jats:italic>via<\/jats:italic>retrograde transport. We hypothesize that a glial inflammatory response may contribute to damaged oligodendrocytes and blood brain barrier (BBB) breakdown, allowing a second route for CNS invasion and lymphocyte infiltration. Potential for molecular mimicry and the stimulation of autoreactive T cells against myelin is also described. It is imperative that further studies on SARS-CoV-2 neuroinvasion address the adverse effects of the virus on myelin and exacerbation of MS symptoms, as nearly 3 million people suffer from MS worldwide.<\/jats:p>","DOI":"10.3389\/fimmu.2022.871276","type":"journal-article","created":{"date-parts":[[2022,4,22]],"date-time":"2022-04-22T04:56:50Z","timestamp":1650603410000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":27,"title":["SARS-CoV-2 and Multiple Sclerosis: Potential for Disease Exacerbation"],"prefix":"10.3389","volume":"13","author":[{"given":"Madison","family":"MacDougall","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jad","family":"El-Hajj Sleiman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Beauchemin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manu","family":"Rangachari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520970841","article-title":"Rising Prevalence of Multiple Sclerosis Worldwide: Insights From the Atlas of MS, Third Edition","volume":"26","author":"Walton","year":"2020","journal-title":"Mult Scler J"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.4103\/1673-5374.245462","article-title":"The Role of Epstein-Barr Virus in Multiple Sclerosis: From Molecular Pathophysiology to In Vivo Imaging","volume":"14","author":"Guan","year":"2019","journal-title":"Neural Regener Res"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1177\/1352458520907901","article-title":"Systematic Review and Meta-Analysis of the Association Between Epstein\u2013Barr Virus, Multiple Sclerosis and Other Risk Factors","volume":"26","author":"Jacobs","year":"2020","journal-title":"Mult Scler"},{"key":"B4","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1126\/science.abj8222","article-title":"Longitudinal Analysis Reveals High Prevalence of Epstein-Barr Virus Associated With Multiple Sclerosis","volume":"375","author":"Bjornevik","year":"2022","journal-title":"Science"},{"key":"B5","doi-asserted-by":"publisher","first-page":"102377","DOI":"10.1016\/j.msard.2020.102377","article-title":"Multiple Sclerosis Following SARS-CoV-2 Infection","volume":"45","author":"Palao","year":"2020","journal-title":"Mult Scler Relat Disord"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00701-020-04374-x","article-title":"SARS-CoV-2 Can Induce Brain and Spine Demyelinating Lesions","volume":"162","author":"Zanin","year":"2020","journal-title":"Acta Neurochir (Wien)"},{"key":"B7","doi-asserted-by":"publisher","first-page":"102324","DOI":"10.1016\/j.msard.2020.102324","article-title":"A Case of Possible Atypical Demyelinating Event of the Central Nervous System Following COVID-19","volume":"44","author":"Zoghi","year":"2020","journal-title":"Mult Scler Relat Disord"},{"key":"B8","doi-asserted-by":"publisher","first-page":"103368","DOI":"10.1016\/j.msard.2021.103368","article-title":"\u00bf Can COVID-19 Exacerbate Multiple Sclerosis Symptoms? 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