Biomedical and Environmental Sciences

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Report on Cardiovascular Health and Diseases in China 2023: An Updated Summary (30 day view times: 67)

National Center for Cardiovascular Diseases The Writing Committee of the Report on Cardiovascular Health and Diseases in China

2024, 37(9): 949-992. doi: 10.3967/bes2024.162

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Since 1990, China has made considerable progress in resolving the problem of “treatment difficulty” of cardiovascular diseases (CVD). The prevalent unhealthy lifestyle among Chinese residents has exposed a massive proportion of the population to CVD risk factors, and this situation is further worsened due to the accelerated aging population in China. CVD remains one of the greatest threats to the health of Chinese residents. In terms of the proportions of disease mortality among urban and rural residents in China, CVD has persistently ranked first. In 2021, CVD accounted for 48.98% and 47.35% of deaths in rural and urban areas, respectively. Two out of every five deaths can be attributed to CVD. To implement a national policy “focusing on the primary health institute and emphasizing prevention” and truly achieve a shift of CVD prevention and treatment from hospitals to communities, the National Center for Cardiovascular Diseases has organized experts from relevant fields across China to compile the “Report on Cardiovascular Health and Diseases in China” annually since 2005. The 2024 report is established based on representative, published, and high-quality big-data research results from cross-sectional and cohort population epidemiological surveys, randomized controlled clinical trials, large sample registry studies, and typical community prevention and treatment cases, along with data from some projects undertaken by the National Center for Cardiovascular Diseases. These firsthand data not only enrich the content of the current report but also provide a more timely and comprehensive reflection of the status of CVD prevention and treatment in China.

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Effectiveness of Pentavalent Rotavirus Vaccine — a Propensity Score Matched Test Negative Design Case-Control Study Using Medical Big Data in Three Provinces of China (30 day view times: 43)

Yuexin Xiu, Lin Tang, Fuzhen Wang, Lei Wang, Zhen Li, Jun Liu, Dan Li, Xueyan Li, Yao Yi, Fan Zhang, Lei Yu, Jingfeng Wu, Zundong Yin

2025, 38(9): 1032-1043. doi: 10.3967/bes2025.056

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Objective The objective of our study was to evaluate the vaccine effectiveness (VE) of the pentavalent rotavirus vaccine (RV5) among < 5-year-old children in three provinces of China during 2020–2024 via a propensity score-matched test-negative case-control study. Methods Electronic health records and immunization information systems were used to obtain data on acute gastroenteritis (AGE) cases tested for rotavirus (RV) infection. RV-positive cases were propensity score matched with RV-negative controls for age, visit month, and province. Results The study included 27,472 children with AGE aged 8 weeks to 4 years at the time of AGE diagnosis; 7.98% (2,192) were RV-positive. The VE (95% confidence interval, CI) of 1–2 and 3 doses of RV5 against any medically attended RV infection (inpatient or outpatient) was 57.6% (39.8%, 70.2%) and 67.2% (60.3%, 72.9%), respectively. Among children who received the 3rd dose before turning 5 months of age, 3-dose VE decreased from 70.4% (53.9%, 81.1%) (< 5 months since the 3rd dose) to 63.0% (49.1%, 73.0%) (≥ 1 year since the 3rd dose). The three-dose VE rate was 69.4% (41.3%, 84.0%) for RVGE hospitalization and 57.5% (38.9%, 70.5%) for outpatient-only medically attended RVGE. Conclusion Three-dose RV5 VE against rotavirus gastroenteritis (RVGE) in children aged < 5 years was higher than 1-2-dose VE. Three-dose VE decreased with time since the 3rd dose in children who received the 3rd dose before turning five months of age, but remained above 60% for at least one year. VE was higher for RVGE hospitalizations than for medically attended outpatient visits.

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Interpretation of Annual Report on Cardiovascular Health and Diseases in China 2024 (30 day view times: 36)

Mingbo Liu, Xinye He, Xiaohong Yang, Zengwu Wang

2025, 38(8): 893-917. doi: 10.3967/bes2025.099

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Cardiovascular diseases (CVD) and their risk factors are exerting an increasingly significant impact on public health, and the incidence rate of CVD continues to rise. This article provides an interpretation of essentials from the newly published Annual Report on Cardiovascular Health and Diseases in China (2024), aiming to offer scientific evidence for CVD prevention, treatment, and the formulation of relevant policies.

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Hypertrophic Cardiomyopathy: Mechanisms of Pathogenicity (30 day view times: 32)

Baoxi Wang, Yueting Zhou, Yipin Zhao, Yong Cheng, Jun Ren, Guanchang Tan, Xiaohu Wang

2025, 38(8): 988-1000. doi: 10.3967/bes2025.096

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Hypertrophic cardiomyopathy (HCM) is a major contributor to cardiovascular diseases (CVD), the leading cause of death globally. HCM can precipitate heart failure (HF) by causing the cardiac tissue to weaken and stretch, thereby impairing its pumping efficiency. Moreover, HCM increases the risk of atrial fibrillation, which in turn elevates the likelihood of thrombus formation and stroke. Given these significant clinical ramifications, research into the etiology and pathogenesis of HCM is intensifying at multiple levels. In this review, we discuss and synthesize the latest findings on HCM pathogenesis, drawing on key experimental studies conducted both in vitro and in vivo. We also offer our insights and perspectives on these mechanisms, while highlighting the limitations of current research. Advancing fundamental research in this area is essential for developing effective therapeutic interventions and enhancing the clinical management of HCM.

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Environmental Temperature and the Risk of Hand, Foot, and Mouth Disease Transmission in the Yangtze River Region of China (30 day view times: 25)

Yanqing Yang, Min Chen, Jin Li, Kaiqi Liu, Xueyan Guo, Xin Xu, Qian Liang, Xinglu Wu, Suwen Lei, Jing Li

2025, 38(3): 290-302. doi: 10.3967/bes2025.011

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Objective To assess health equity in the Yangtze River region to improve understanding of the correlation between hand, foot, and mouth disease (HFMD) and socioeconomic factors. Methods From 2014–2016, data on HFMD incidence, population statistics, economic indicators, and meteorology from 26 cities along the Yangtze River were analyzed. A multi-city random-effects meta-analysis was performed to study the relationship between temperature and HFMD transmission, and health equity was assessed with respect to socio-economic impact. Results Over the study period, 919,458 HFMD cases were reported, with Shanghai (162,303) having the highest incidence and Tongling (5,513) having the lowest. Males were more commonly affected (male-to-female ratio, 1.49:1). The exposure-response relationship had an M-shaped curve, with two HFMD peaks occurring at 4 °C and 26 °C. The relative risk had two peaks at 1.30 °C (1.834, 95% CI: 1.204–2.794) and 31.4 °C (1.143, 95% CI: 0.901–1.451), forming an M shape, with the first peak higher than the second. The most significant impact of temperature on HFMD was observed between –2 °C and 18.1 °C. The concentration index (0.2463) indicated moderate concentration differences, whereas the Theil index (0.0418) showed low inequality in distribution. Conclusion The incidence of HFMD varied across cities, particularly with changes in temperature. Economically prosperous areas showed higher risks, indicating disparities. Targeted interventions in these areas are crucial for mitigating the risk of HFMD.

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The Association between GLP-1 Receptor-Based Agonists and the Incidence of Asthma in Patients with Type 2 Diabetes and/or Obesity: A Meta-Analysis (30 day view times: 25)

Mengqing Zhang, Chu Lin, Xiaoling Cai, Ruoyang Jiao, Shuzhen Bai, Zonglin Li, Suiyuan Hu, Fang Lyu, Wenjia Yang, Linong Ji

2024, 37(6): 607-616. doi: 10.3967/bes2024.067

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Objective Recent studies have indicated potential anti-inflammatory effects of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on asthma, which is often comorbid with type 2 diabetes mellitus (T2DM) and obesity. Therefore, we conducted a meta-analysis to assess the association between the administration of glucagon-like peptide-1 (GLP-1) receptor-based agonists and the incidence of asthma in patients with T2DM and/or obesity. Methods PubMed, Web of Science, Embase, the Cochrane Central Register of Controlled Trials, and Clinicaltrial.gov were systematically searched from inception to July 2023. Randomized controlled trials (RCTs) of GLP-1 receptor-based agonists (GLP-1RA, GLP-1 based dual and triple receptor agonist) with reports of asthma events were included. Outcomes were computed as risk ratios (RR) using a fixed-effects model. Results Overall, 39 RCTs with a total of 85,755 participants were included. Compared to non-GLP-1 receptor-based agonist users, a trend of reduced risk of asthma was observed in patients with T2DM or obesity using GLP-1 receptor-based agonist treatments, although the difference was not statistically significant [RR = 0.91, 95% confidence interval (CI): 0.68 to 1.24]. Further Subgroup analyses indicated that the use of light-molecular-weight GLP-1RAs might be associated with a reduced the risk of asthma when compared with non-users (RR = 0.65, 95% CI: 0.43 to 0.99, P = 0.043). We also performed sensitivity analyses for participant characteristics, study design, drug structure, duration of action, and drug subtypes. However, no significant associations were observed. Conclusion Compared with non-users, a modest reduction in the incidence of asthma was observed in patients with T2DM or obesity using GLP-1 receptor-based agonist treatments. Further investigations are warranted to assess the association between GLP-1 receptor-based agonists and the risk of asthma.

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Climate-Sensitive Infectious Diseases under Global Climate Change (30 day view times: 23)

Qiao Liu, Min Liu, Jue Liu

2025, 38(9): 1129-1141. doi: 10.3967/bes2025.077

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Climate and weather significantly influence the duration, timing, and intensity of disease outbreaks, reshaping the global landscape of infectious diseases. Rising temperatures and shifts in precipitation patterns driven by climate change can directly impact the survival and reproduction of pathogens and vector organisms. Moreover, climate change is expected to exacerbate extreme weather events, including floods and droughts, which can disrupt infrastructure and increase the risk of water- and foodborne diseases. There are potential shifts in the temporal and spatial patterns of infectious disease transmission owing to climate change. Furthermore, climate change may alter the epidemiology of vaccine-preventable diseases. These climatic variations not only affect the ecological characteristics of pathogens and vectors but also indirectly influence human behaviors and socioeconomic conditions, further amplifying disease transmission risks. Addressing this challenge requires an interdisciplinary collaboration and comprehensive public health strategies. This review aims to synthesize the current evidence on the impact of climate change on climate-sensitive infectious diseases and elucidate the underlying mechanisms and transmission pathways. Additionally, we explored adaptive policy strategies to mitigate the public health burden of infectious diseases in the context of climate change, offering insights for global health governance and disease control efforts.

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Report on Cardiovascular Health and Diseases in China 2022: an Updated Summary (30 day view times: 22)

The Writing Committee of the Report on Cardiovascular Health and Diseases in China

2023, 36(8): 669-701. doi: 10.3967/bes2023.106

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In the past 30 years, the accessibility and quality index of medical care have made remarkable progress in China, ranking the first among middle-income countries. Many cardiovascular technologies are at or near the world's leading level, and significant progress has been achieved in China solving the problem of “treatment difficulty” of cardiovascular diseases (CVD). However, due to the prevalence of unhealthy lifestyles among Chinese residents, a huge population with CVD risk factors, accelerated population aging, and other reasons, the incidence and mortality rate of CVD are still increasing, and the turning point of the decline in disease burden has not appeared yet in China. In terms of proportions of disease mortality among urban and rural residents, CVD still ranks the first. In 2020, CVD accounted for 48.00% and 45.86% of the causes of death in rural and urban areas, respectively; two out of every five deaths were due to CVD. It is estimated that the number of current CVD patients in China is around 330 million, including 13 million stroke, 11.39 million coronary heart disease, 8.9 million heart failure, 5 million pulmonary heart disease, 4.87 million atrial fibrillation, 2.5 million rheumatic heart disease, 2 million congenital heart disease, 45.3 million peripheral artery disease, and 245 million hypertension cases. China has entered a new stage of transformation from high-speed development to high-quality development, and the prevention and control of CVD in China should also shift from previous emphasis on scale growth to strategies focusing more on strategic and key technological development in order to curb the trend of increasing incidence and mortality rates of CVD.

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Molecular Characterization of New Recombinant Human Adenoviruses Detected in Children with Acute Respiratory Tract Infections in Beijing, China, 2022–2023 (30 day view times: 22)

Yinan Guo, Ri De, Fangming Wang, Zhenzhi Han, Liying Liu, Yu Sun, Yao Yao, Xiaolin Ma, Shuang Liu, Chunmei Zhu, Dong Qu, Linqing Zhao

2025, 38(9): 1071-1081. doi: 10.3967/bes2025.105

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Objective Recombination events are common and serve as the primary driving force of diverse human adenovirus (HAdV), particularly in children with acute respiratory tract infections (ARIs). Therefore, continual monitoring of these events is essential for effective viral surveillance and control. Methods Respiratory specimens were collected from children with ARIs between January 2022 and December 2023. The penton base, hexon, and fiber genes were amplified from HAdV-positive specimens and sequenced to determine the virus type. In cases with inconsistent typing results, genes were cloned into the pGEM-T vector to detect recombination events. Metagenomic next-generation sequencing (mNGS) was performed to characterize the recombinant HAdV genomes. Results Among 6,771 specimens, 277 (4.09%, 277/6,771) were positvie for HAdV, of which 157 (56.68%, 157/277) were successfully typed, with HAdV-B3 being the dominant type (91.08%, 143/157), and 14 (5.05%, 14/277) exhibited inconsistent typing results, six of which belonged to species B. The penton base genes of these six specimens were classified as HAdV-B7, whereas their hexon and fiber genes were classified as HAdV-B3, resulting in a recombinant genotype designated P7H3F3, which closely resembled HAdV-B114. Additionally, a partial gene encoding L1 52/55 kD was identified, which originated from HAdV-B16. Conclusion A novel recombinant, P7H3F3, was identified, containing sequences derived from HAdV-B3 and HAdV-B7, which is similar to HAdV-B114, along with additional sequences from HAdV-B16.

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Integrating Internet Search Data and Surveillance Data to Construct Influenza Epidemic Thresholds in Hubei Province: A Moving Epidemic Method Approach (30 day view times: 21)

Caixia Dang, Feng Liu, Hengliang Lyu, Ziqian Zhao, Sijin Zhu, Yang Wang, Yuanyong Xu, Yeqing Tong, Hui Chen

2025, 38(9): 1150-1154. doi: 10.3967/bes2025.109

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Burden of Headache Disorders in China and its Provinces, 1990–2021 (30 day view times: 18)

Zhe Liu, Xuehua Hu, Lin Yang, Jinlei Qi, Jiangmei Liu, Lijun Wang, Maigeng Zhou, Peng Yin

2025, 38(5): 547-556. doi: 10.3967/bes2025.019

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Objective To analyze the prevalence and burden of headache disorders in China and its provinces from 1990 to 2021. Methods Using data from the Global Burden of Disease Study (GBD) 2021, the number of prevalent cases, prevalence rate, disability-adjusted life years (DALYs), and age-standardized DALY rates were analyzed by sex, age group, and province for headache disorders and their subtypes (migraine and tension-type headache [TTH]) between 1990 and 2021. Percentage changes during this period were also estimated. Results In 2021, approximately 426 million individuals in China were affected by headache disorders, with an age-standardized prevalence rate of 27,582.61/100,000. The age-standardized DALY rate for all headache disorders was 487.15/100,000. Between 1990 and 2021, the number of prevalent cases increased by 37.78%, while the prevalence of all headache disorders, migraine, and TTH increased by 6.92%, 7.57%, and 7.86%, respectively. The highest prevalence was observed in the 30–34 age group (39,520.60/100,000). Migraine accounted for a larger proportion of DALYs attributable to headache disorders, whereas TTH has a greater impact on its prevalence. In 2021, the highest age-standardized DALY rates for headache disorders were observed in Heilongjiang (617.85/100,000) and Shanghai (542.86/100,000). Conclusion The prevalence of headache disorders is increasing in China. Effective health education, improve diagnosis and treatment are essential, particularly for middle-aged working populations and women of childbearing age.

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Association of Dietary Preferences with All-Cause and Cause-Specific Mortality: Prospective Cohort Study of 1,160,312 Adults in China (30 day view times: 17)

Wenru Shi, Sitong Wei, Qingmei Huang, Huan Chen, Dong Shen, Bofeng Zhu, Chen Mao

2025, 38(9): 1120-1128. doi: 10.3967/bes2025.108

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Objective Although dietary preferences influence chronic diseases, few studies have linked dietary preferences to mortality risk, particularly in large cohorts. To investigate the relationship between dietary preferences and mortality risk (all-cause, cancer, and cardiovascular disease [CVD]) in a large adult cohort. Methods A cohort of 1,160,312 adults (mean age 62.48 ± 9.55) from the Shenzhen Healthcare Big Data Cohort (SHBDC) was analyzed. Hazard ratios (HRs) for mortality were estimated using the Cox proportional hazards model. Results The study identified 12,308 all-cause deaths, of which 3,865 (31.4%) were cancer-related and 3,576 (29.1%) were attributed to CVD. Compared with a mixed diet of meat and vegetables, a mainly meat-based diet (hazard ratio [HR] = 1.13; 95% confidence interval [CI]: 1.02, 1.27) associated with a higher risk of all-cause mortality, while mainly vegetarian (HR = 0.87; 95% CI: 0.78, 0.97) was linked to a reduced risk. Furthermore, there was a stronger correlation between mortality risk and dietary preference in the > 65 age range. Conclusion A meat-based diet was associated with an increased risk of all-cause mortality, whereas a mainly vegetarian diet was linked to a reduced risk.

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Correlation between Anxiety, Depression, and Sleep Quality in College Students (30 day view times: 17)

ZHANG Yu Tong, HUANG Tao, ZHOU Fang, HUANG Ao Di, JI Xiao Qi, HE Lu, GENG Qiang, WANG Jia, MEI Can, XU Yu Jia, YANG Ze Long, ZHAN Jian Bo, CHENG Jing

2022, 35(7): 648-651. doi: 10.3967/bes2022.084

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The Impacts of Climate Change on the Environment and Human Health in China: A Call for more Ambitious Action (30 day view times: 16)

Shilu Tong, Yu Wang, Yonglong Lu, Cunde Xiao, Qiyong Liu, Qi Zhao, Cunrui Huang, Jiayu Xu, Ning Kang, Tong Zhu, Dahe Qin, Ying Xu, Buda Su, Xiaoming Shi

2025, 38(2): 127-143. doi: 10.3967/bes2025.016

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As global greenhouse gases continue rising, the urgency of more ambitious action is clearer than ever before. China is the world’s biggest emitter of greenhouse gases and one of the countries affected most by climate change. The evidence about the impacts of climate change on the environment and human health may encourage China to take more decisive action to mitigate greenhouse gas emissions and adapt to climate impacts. This article aimed to review the evidence of environmental damages and health risks posed by climate change and to provide a new science-based perspective for the delivery of sustainable development goals. Over recent decades, China has experienced a strong warming pattern with a growing frequency of extreme weather events, and the impacts of climate change on China’s environment and human health have been consistently observed, with increasing O₃ air pollution, decreases in water resources and availability, land degradation, and increased risks for both communicable and non-communicable diseases. Therefore, China’s climate policy should target the key factors driving climate change and scale up strategic measures to curb carbon emissions and adapt to inevitable increasing climate impacts. It provides new insights for not only China but also other countries, particularly developing and emerging economies, to ensure climate and environmental sustainability whilst pursuing economic growth.

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Trends in Lipids Level and Dyslipidemia among Chinese Adults, 2002-2015 (30 day view times: 16)

SONG Peng Kun, MAN Qing Qing, LI Hong, PANG Shao Jie, JIA Shan Shan, LI Yu Qian, HE Li, ZHAO Wen Hua, ZHANG Jian

2019, 32(8): 559-570. doi: 10.3967/bes2019.074

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Objective To investigate the trends of lipid profiles and dyslipidemia among Chinese adults from 2002 to 2015. Methods Data were collected from three nationally representative cross-sectional surveys. Fasting venous blood samples were collected and serum lipids were tested by biochemical analysis and enzymatic determination. Lipid levels and the prevalence of dyslipidemia among adults were analyzed with complex sampling weighting adjustment for age and gender. Results The weighted means of TC, TG, and LDL-c significantly increased linearly from 3.93, 1.12, and 2.12 mmol/L in 2002 to 4.59, 1.41, and 2.78 mmol/L in 2010 and then to 4.63, 1.47, and 2.87 mmol/L in 2015, respectively; by contrast, HDL-c levels decreased significantly from 1.30 mmol/L to 1.26 mmol/L over the same period. Similar trends in mean non-HDL-c and lipid-related ratios were observed. The weighted dyslipidemia prevalence linearly increased; in particular, hypercholesterolemia increased from 1.6% to 5.6% and then to 5.8%, hypertriglyceridemia increased from 5.7% to 13.6% and then to 15.0%, low HDL-c increased from 18.8% to 35.5% and then to 24.9%, and high LDL-c increased from 1.3% to 5.6% and then to 7.2% (P for trend < 0.001). Conclusion Dyslipidemia increased among Chinese adults from 2002 to 2015. Development of a comprehensive strategy to decrease lipid levels in this population is urgently required.

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Cardiovascular Health and Disease Report in China: Two Decades of Progress (30 day view times: 15)

Shuyao Su, Fangchao Liu

2025, 38(8): 891-892. doi: 10.3967/bes2025.098

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Physical Activity Guidelines for Chinese (2021) (30 day view times: 15)

Composing and Editorial Board of Physical Activity Guidelines for Chinese

2022, 35(1): 1-3. doi: 10.3967/bes2022.001

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A Health Economic Evaluation of an Artificial Intelligence-assisted Prescription Review System in a Real-world Setting in China (30 day view times: 15)

Di Wu, Yingpeng Qiu, Liwei Shi, Kejun Liu, Xueqing Tian, Ping Ren, Mao You, Junrui Pei, Wenqi Fu, Yue Xiao

2025, 38(3): 385-388. doi: 10.3967/bes2025.025

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Evidence on Invasion of Blood, Adipose Tissues, Nervous System and Reproductive System of Mice After a Single Oral Exposure: Nanoplastics versus Microplastics (30 day view times: 14)

YANG Zuo Sen, BAI Ying Long, JIN Cui Hong, NA Jun, ZHANG Rui, GAO Yuan, PAN Guo Wei, YAN Ling Jun, SUN Wei

2022, 35(11): 1025-1037. doi: 10.3967/bes2022.131

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Objective This study was designed to provide the evidences on the toxicokinetics of microplastics (MPs) and nanoplastics (NPs) in the bodies of mammals. Methods 100 nm, 3 μm, and 10 μm fluorescent polystyrene (PS) beads were administered to mice once by gavage at a dose of 200 mg/kg body weight. The levels and change of fluorescence intensity in samples of blood, subcutaneous fat, perirenal fat, peritesticular fat, cerebrum, cerebellum, testis, and epididymis were measured at 0.5, 1, 2, and 4 h after administration using an IVIS Spectrum small-animal imaging system. Histological examination, confocal laser scanning, and transmission electron microscope were performed to corroborate the findings. Results After confirming fluorescent dye leaching and impact of pH value, increased levels of fluorescence intensity in blood, all adipose tissues examined, cerebrum, cerebellum, and testis were measured in the 100 nm group, but not in the 3 and 10 μm groups except in the cerebellum and testis at 4 h for the 3 μm PS beads. The presence of PS beads was further corroborated. Conclusion After a single oral exposure, NPs are absorbed rapidly in the blood, accumulate in adipose tissues, and penetrate the blood-brain/testis barriers. As expected, the toxicokinetics of MPs is significantly size-dependent in mammals.

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Pathogenicity and Transcriptomic Profiling Revealed Activation of Apoptosis and Pyroptosis in Brain of Mice Infected with the Beta Variant of SARS-CoV-2 (30 day view times: 14)

Han Li, Baoying Huang, Gaoqian Zhang, Fei Ye, Li Zhao, Weibang Huo, Zhongxian Zhang, Wen Wang, Wenling Wang, Xiaoling Shen, Changcheng Wu, Wenjie Tan

2025, 38(9): 1082-1094. doi: 10.3967/bes2025.106

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Objective Patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection frequently develop central nervous system damage, yet the mechanisms driving this pathology remain unclear. This study investigated the primary pathways and key factors underlying brain tissue damage induced by the SARS-CoV-2 beta variant (lineage B.1.351). Methods K18-hACE2 and C57BL/6 mice were intranasally infected with the SARS-CoV-2 beta variant. Viral replication, pathological phenotypes, and brain transcriptomes were analyzed. Gene Ontology (GO) analysis was performed to identify altered pathways. Expression changes of host genes were verified using reverse transcription-quantitative polymerase chain reaction and Western blot. Results Pathological alterations were observed in the lungs of both mouse strains. However, only K18-hACE2 mice exhibited elevated viral RNA loads and infectious titers in the brain at 3 days post-infection, accompanied by neuropathological injury and weight loss. GO analysis of infected K18-hACE2 brain tissue revealed significant dysregulation of genes associated with innate immunity and antiviral defense responses, including type I interferons, pro-inflammatory cytokines, Toll-like receptor signaling components, and interferon-stimulated genes. Neuroinflammation was evident, alongside activation of apoptotic and pyroptotic pathways. Furthermore, altered neural cell marker expression suggested viral-induced neuroglial activation, resulting in caspase 4 and lipocalin 2 release and disruption of neuronal molecular networks. Conclusion These findings elucidate mechanisms of neuropathogenicity associated with the SARS-CoV-2 beta variant and highlight therapeutic targets to mitigate COVID-19-related neurological dysfunction.

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