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COVID-19 viral RNA and antigens have been detected in the cerebrospinal fluid and the brain tissue, indicating that the virus can cross the bloodbrain barrier to invade the central nervous system ( via extracellular vesicles and direct intercellular transmission ( The COVID-19 virus can colonize the brain, leading to neuronal death and inflammation ( COVID-19 can induce cytokine storms and neuroinflammation, leading to neuronal damage and decreased cognitive function

Similar neuroprotective effects have been observed in mouse models of rotenone-induced PD as well, through the inhibition of -synuclein phosphorylation and aggregation, protection of mitochondrial function, inhibition of neuroinflammation, modulation of autophagy, attenuation of oxidative stress and restoration of ER balance (Wang D

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It is found that these two markers started to increase even when B12 level was still above its lower limit of 148 pmol/L (200 pg/L), as such they are considered as more sensitive markers and may help for diagnosis of B12 deficiency