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In the early days of the COVID-19 pandemic, as Diana Bautista and others in her UC Berkeley lab suffered sneezing and coughing fits and achy bodies, she asked an interesting scientific question: How, exactly, do viruses cause the noxious symptoms we're all familiar with from bouts with colds, the flu and COVID?

Five years later—and after a detour to prove to scientific reviewers that her experimental subjects, mice, do sneeze—she has the beginnings of an answer. She now devotes more than half of her energy and lab staff to investigating the wiles of coronaviruses like SARS-CoV-2 and how they interact with the nervous system and the immune system to give us a headache—literally.

In the journal Neuron, she and her colleagues report that SARS-CoV-2 proteins stimulate sensory nerves directly, triggering sneezing, coughing and pain. The prevailing view was that these symptoms come from inflammatory mediators released by infected epithelial and immune cells acting on sensory neurons. This study shows there is another route by which viruses trigger sneezing, coughing and respiratory dysfunction.

This is the first evidence that viral proteins can directly activate sensory nerves to promote viral symptoms and could lead to therapeutic interventions. This direct activation may also help explain some of the chronic conditions associated with long COVID, including headache, shortness of breath, persistent cough, sore throat and chest pain.

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