Biological and Psychological Factors Determining Neuropsychiatric Outcomes in COVID-19

Overview

Journal Curr Psychiatry Rep

Publisher Current Science

Specialty Psychiatry

Date 2021 Oct 14

PMID 34648081

Citations 15

Authors

Boris N Tizenberg

Lisa A Brenner

Christopher A Lowry

Olaoluwa O Okusaga

David R Benavides

Andrew J Hoisington

Michael E Benros

John W Stiller

Ronald C Kessler

Teodor T Postolache

Affiliations

Soon will be listed here.

Abstract

Purpose Of Review: We present biological and psychological factors implicated in psychiatric manifestations of SARS-CoV-2, as well as its neuroinvasive capability and immune pathophysiology.

Recent Findings: Preexisting mental illness leads to worse clinical outcomes in COVID-19. The presence of the virus was reported in the cerebrospinal fluid (CSF) and brain tissue post-mortem. Most common psychiatric manifestations include delirium, mood disorders, anxiety disorders, and posttraumatic stress disorder. "Long-COVID" non-syndromal presentations include "brain-fogginess," autonomic instability, fatigue, and insomnia. SARS-CoV-2 infection can trigger prior vulnerabilities based on the priming of microglia and other cells, induced or perpetuated by aging and mental and physical illnesses. COVID-19 could further induce priming of neuroimmunological substrates leading to exacerbated immune response and autoimmunity targeting structures in the central nervous system (CNS), in response to minor immune activating environmental exposures, including stress, minor infections, allergens, pollutants, and traumatic brain injury.

Citing Articles

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References

Zhao J, Yuan Q, Wang H, Liu W, Liao X, Su Y . Antibody Responses to SARS-CoV-2 in Patients With Novel Coronavirus Disease 2019. Clin Infect Dis. 2020; 71(16):2027-2034. PMC: 7184337. DOI: 10.1093/cid/ciaa344. View

Davido B, Seang S, Tubiana R, De Truchis P . Post-COVID-19 chronic symptoms: a postinfectious entity?. Clin Microbiol Infect. 2020; 26(11):1448-1449. PMC: 7376333. DOI: 10.1016/j.cmi.2020.07.028. View

Barcella C, Polcwiartek C, Mohr G, Hodges G, Sondergaard K, Bang C . Severe mental illness is associated with increased mortality and severe course of COVID-19. Acta Psychiatr Scand. 2021; 144(1):82-91. PMC: 8250986. DOI: 10.1111/acps.13309. View

Hung T, Tsai C, Lee H . Statin use in cirrhotic patients with infectious diseases: A population-based study. PLoS One. 2019; 14(4):e0215839. PMC: 6481830. DOI: 10.1371/journal.pone.0215839. View

Toubasi A, AbuAnzeh R, Tawileh H, Aldebei R, AlRyalat S . A meta-analysis: The mortality and severity of COVID-19 among patients with mental disorders. Psychiatry Res. 2021; 299:113856. PMC: 7927594. DOI: 10.1016/j.psychres.2021.113856. View

Wrapp D, Wang N, Corbett K, Goldsmith J, Hsieh C, Abiona O . Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science. 2020; 367(6483):1260-1263. PMC: 7164637. DOI: 10.1126/science.abb2507. View

Najjar S, Najjar A, Chong D, Pramanik B, Kirsch C, Kuzniecky R . Central nervous system complications associated with SARS-CoV-2 infection: integrative concepts of pathophysiology and case reports. J Neuroinflammation. 2020; 17(1):231. PMC: 7406702. DOI: 10.1186/s12974-020-01896-0. View

Puelles V, Lutgehetmann M, Lindenmeyer M, Sperhake J, Wong M, Allweiss L . Multiorgan and Renal Tropism of SARS-CoV-2. N Engl J Med. 2020; 383(6):590-592. PMC: 7240771. DOI: 10.1056/NEJMc2011400. View

Arbour N, Ekande S, Cote G, Lachance C, Chagnon F, Tardieu M . Persistent infection of human oligodendrocytic and neuroglial cell lines by human coronavirus 229E. J Virol. 1999; 73(4):3326-37. PMC: 104097. DOI: 10.1128/JVI.73.4.3326-3337.1999. View

10.

Lu R, Zhao X, Li J, Niu P, Yang B, Wu H . Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020; 395(10224):565-574. PMC: 7159086. DOI: 10.1016/S0140-6736(20)30251-8. View

11.

Godbout J, Chen J, Abraham J, Richwine A, Berg B, Kelley K . Exaggerated neuroinflammation and sickness behavior in aged mice following activation of the peripheral innate immune system. FASEB J. 2005; 19(10):1329-31. DOI: 10.1096/fj.05-3776fje. View

12.

Nicholls J, Butany J, Poon L, Chan K, Beh S, Poutanen S . Time course and cellular localization of SARS-CoV nucleoprotein and RNA in lungs from fatal cases of SARS. PLoS Med. 2005; 3(2):e27. PMC: 1324951. DOI: 10.1371/journal.pmed.0030027. View

13.

Cai X, Hu X, Ekumi I, Wang J, An Y, Li Z . Psychological Distress and Its Correlates Among COVID-19 Survivors During Early Convalescence Across Age Groups. Am J Geriatr Psychiatry. 2020; 28(10):1030-1039. PMC: 7347493. DOI: 10.1016/j.jagp.2020.07.003. View

14.

Murin C, Wilson I, Ward A . Antibody responses to viral infections: a structural perspective across three different enveloped viruses. Nat Microbiol. 2019; 4(5):734-747. PMC: 6818971. DOI: 10.1038/s41564-019-0392-y. View

15.

Ku Z, Xie X, Hinton P, Liu X, Ye X, Muruato A . Nasal delivery of an IgM offers broad protection from SARS-CoV-2 variants. Nature. 2021; 595(7869):718-723. PMC: 8742224. DOI: 10.1038/s41586-021-03673-2. View

16.

Cantuti-Castelvetri L, Ojha R, Pedro L, Djannatian M, Franz J, Kuivanen S . Neuropilin-1 facilitates SARS-CoV-2 cell entry and infectivity. Science. 2020; 370(6518):856-860. PMC: 7857391. DOI: 10.1126/science.abd2985. View

17.

Eshak N, Abdelnabi M, Ball S, Elgwairi E, Creed K, Test V . Dysautonomia: An Overlooked Neurological Manifestation in a Critically ill COVID-19 Patient. Am J Med Sci. 2020; 360(4):427-429. PMC: 7366085. DOI: 10.1016/j.amjms.2020.07.022. View

18.

Arbour N, Cote G, Lachance C, Tardieu M, Cashman N, Talbot P . Acute and persistent infection of human neural cell lines by human coronavirus OC43. J Virol. 1999; 73(4):3338-50. PMC: 104098. DOI: 10.1128/JVI.73.4.3338-3350.1999. View

19.

Osipova E, Semyachkina-Glushkovskaya O, Morgun A, Pisareva N, Malinovskaya N, Boitsova E . Gliotransmitters and cytokines in the control of blood-brain barrier permeability. Rev Neurosci. 2018; 29(5):567-591. DOI: 10.1515/revneuro-2017-0092. View

20.

Schmidt F, Weschenfelder J, Sander C, Minkwitz J, Thormann J, Chittka T . Inflammatory cytokines in general and central obesity and modulating effects of physical activity. PLoS One. 2015; 10(3):e0121971. PMC: 4363366. DOI: 10.1371/journal.pone.0121971. View