Olfactory transmucosal SARS-CoV-2 invasion as port of Central Nervous System entry in COVID-19 patients

The newly identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, a pandemic respiratory disease presenting with fever, cough, and often pneumonia. Moreover, thromboembolic events throughout the body including the central nervous system (CNS) have been described. Given first indication for viral RNA presence in the brain and cerebrospinal fluid and in light of neurological symptoms in a large majority of COVID-19 patients, SARS-CoV-2-penetrance of the CNS is likely.

By investigating and anatomically mapping oro- and pharyngeal regions and brains of 33 patients dying from COVID-19, we not only describe CNS infarction due to cerebral thromboembolism, but also demonstrate SARS-CoV-2 neurotropism. SARS-CoV-2 enters the nervous system via trespassing the neuro-mucosal interface in the olfactory mucosa by exploiting the close vicinity of olfactory mucosal and nervous tissue including delicate olfactory and sensitive nerve endings. Subsequently, SARS-CoV-2 follows defined neuroanatomical structures, penetrating defined neuroanatomical areas, including the primary respiratory and cardiovascular control center in the medulla oblongata.

Session 7: Cutting Edge
(Sars-CoV-2) Part 2


October 2, 2020

13:00 -14:00

Dr. Helena Radbruch

Helena Radbruch has studied medicine at Freie Universität Berlin and Université Libré de Bruxelles, Belgium, and finished her doctoral thesis at the Institute of Neuroimmunology, Charité, in 2010. Afterwards she worked as a clinical scientist at the Clinic for Neurology and Clinic for Psychiatry at the Charité for two years and became junior research group leader and resident at the Department of Neuropathology, Charité, in 2012.

As an expert of neuropathology, Helena investigates the pathogenesis of chronic neuro-inflammatory diseases with a focus on B cell dynamics.

Currently, Helena is involved in several COVID-19 patient studies from Charité. Besides respiratory symptoms, it becomes more and more obvious that the central nervous system (CNS) is affected by SARS-CoV-2. Together with her colleagues, Helena investigates how SARS-CoV-2 infection causes neuropathology. She also collaborates with Mir-Farzin Mashreghi from DRFZ to study the immune responses of T and B cells against the novel SARS-CoV-2.


Helena Radbruch at Charité

Helena Radbruch at Research Gate


In severe COVID-19, SARS-CoV-2 induces a chronic, TGF-β-dominated adaptive immune response

Olfactory transmucosal SARS-CoV-2 invasion as port of Central Nervous System entry in COVID-19 patients

Low-Density Granulocytes Are a Novel Immunopathological Feature in Both Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder

The chronically inflamed central nervous system provides niches for long-lived plasma cells

Tracking CNS and systemic sources of oxidative stress during the course of chronic neuroinflammation


Video by „Der Tagespiegel“, Helena Radbruch: Oxidative stress Fingerprint in Chronic inflammation