Review

. 2020;77(2):459-504.

doi: 10.3233/JAD-200831.

COVID-19: Review of a 21st Century Pandemic from Etiology to Neuro-psychiatric Implications

Vicky Yamamoto^{1

2

3

4}, Joe F Bolanos^{1

2}, John Fiallos^{1

2}, Susanne E Strand^{1

2}, Kevin Morris^{1

2}, Sanam Shahrokhinia⁵, Tim R Cushing⁶, Lawrence Hopp⁷, Ambooj Tiwari^{1

8}, Robert Hariri^{1

9

10}, Rick Sokolov¹¹, Christopher Wheeler^{1

2

12}, Ajeet Kaushik¹³, Ashraf Elsayegh¹⁴, Dawn Eliashiv^{1

15}, Rebecca Hedrick¹⁶, Behrouz Jafari¹⁷, J Patrick Johnson^{18

19}, Mehran Khorsandi²⁰, Nestor Gonzalez¹⁹, Guita Balakhani²¹, Shouri Lahiri²², Kazem Ghavidel²³, Marco Amaya^{1

2}, Harry Kloor¹, Namath Hussain^{1

24}, Edmund Huang²¹, Jason Cormier^{1

25}, J Wesson Ashford^{1

26}, Jeffrey C Wang^{1

27}, Shadi Yaghobian²⁸, Payman Khorrami²⁹, Bahman Shamloo³⁰, Charles Moon³¹, Payam Shadi²⁸, Babak Kateb^{1

2

24

32

33}

Affiliations

¹ Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA.
² Brain Mapping Foundation (BMF), Los Angeles, CA, USA.
³ USC Keck School of Medicine, The USC Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, CA, USA.
⁴ USC-Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
⁵ Cedars-Sinai Medical Center, Department of Nutrition, Los Angeles, CA, USA.
⁶ UCLA-Cedar-Sinai California Rehabilitation Institute, Los Angeles, CA, USA.
⁷ Cedars Sinai Medical Center Department of Ophthalmology and UCLA Jules Stein Eye Institute, Los Angeles, CA, USA.
⁸ New York University, Department of Neurology, New York, NY, USA.
⁹ Celularity Corporation, Warren, NJ, USA.
¹⁰ Weill Cornell School of Medicine, Department of Neurosurgery, New York, NY, USA.
¹¹ Cedars-Sinai Medical Center, Department of Infectious Disease Los Angeles, CA, USA.
¹² T-NeuroPharma, Albuquerque, NM, USA.
¹³ NanoBioTech Laboratory, Department of Natural Sciences, Division of Sciences, Arts, and Mathematics, Florida Polytechnic University, Lakeland, FL, USA.
¹⁴ Cedars Sinai Medical Center, Department of Pulmonology, Los Angeles, CA, USA.
¹⁵ UCLA David Geffen, School of Medicine, Department of Neurology, Los Angeles, CA, USA.
¹⁶ Cedars Sinai Medical Center, Department of Psychiatry, Los Angeles, CA, USA.
¹⁷ University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, USA.
¹⁸ Cedars Sinai Medical Center, Spine Institute, Los Angeles, CA, USA.
¹⁹ Cedars-Sinai Medical Center, Department of Neurosurgery, Los Angeles, CA, USA.
²⁰ Cedars-Sinai Medical Center, Department of Cardiology, Los Angeles, CA, USA.
²¹ Cedars-Sinai Medical Center, Department of Nephrology, Los Angeles, CA, USA.
²² Cedars-Sinai Medical Center, Department of Neurology, Los Angeles, CA, USA.
²³ University of Tehran School of Medicine, Department of Cardiology, Tehran, Iran.
²⁴ Loma Linda University, Department of Neurosurgery, Loma Linda, CA, USA.
²⁵ Lafayette Surgical Specialty Hospital, Lafayette, Louisiana, USA.
²⁶ Stanford University School of Medicine (Affiliated), Department of Psychiatry and Behavioral Science and Department of Veteran's Affair, Palo Alto, CA, USA.
²⁷ USC-Keck School of Medicine, Department of Orthopedic Surgery, Los Angeles, CA, USA.
²⁸ Cedars-Sinai Medical Center, Department of Internal Medicine, Los Angeles, CA, USA.
²⁹ Cedars Sinai Medical Center, Department of Gastroenterology, Los Angeles, CA, USA.
³⁰ Cedars Sinai Medical Center, Pain Management, Los Angeles, CA, USA.
³¹ Cedars Sinai Orthopaedic Center, Department of Orthopedics, Los Angeles, CA, USA.
³² National Center for NanoBioElectronic (NCNBE), Los Angeles, CA, USA.
³³ Brain Technology and Innovation Park, Los Angeles, CA, USA.

PMID: 32925078
PMCID: PMC7592693
DOI: 10.3233/JAD-200831

Review

COVID-19: Review of a 21st Century Pandemic from Etiology to Neuro-psychiatric Implications

Vicky Yamamoto et al. J Alzheimers Dis. 2020.

. 2020;77(2):459-504.

doi: 10.3233/JAD-200831.

Authors

Affiliations

¹ Society for Brain Mapping and Therapeutics (SBMT), Los Angeles, CA, USA.
² Brain Mapping Foundation (BMF), Los Angeles, CA, USA.
³ USC Keck School of Medicine, The USC Caruso Department of Otolaryngology-Head and Neck Surgery, Los Angeles, CA, USA.
⁴ USC-Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
⁵ Cedars-Sinai Medical Center, Department of Nutrition, Los Angeles, CA, USA.
⁶ UCLA-Cedar-Sinai California Rehabilitation Institute, Los Angeles, CA, USA.
⁷ Cedars Sinai Medical Center Department of Ophthalmology and UCLA Jules Stein Eye Institute, Los Angeles, CA, USA.
⁸ New York University, Department of Neurology, New York, NY, USA.
⁹ Celularity Corporation, Warren, NJ, USA.
¹⁰ Weill Cornell School of Medicine, Department of Neurosurgery, New York, NY, USA.
¹¹ Cedars-Sinai Medical Center, Department of Infectious Disease Los Angeles, CA, USA.
¹² T-NeuroPharma, Albuquerque, NM, USA.
¹³ NanoBioTech Laboratory, Department of Natural Sciences, Division of Sciences, Arts, and Mathematics, Florida Polytechnic University, Lakeland, FL, USA.
¹⁴ Cedars Sinai Medical Center, Department of Pulmonology, Los Angeles, CA, USA.
¹⁵ UCLA David Geffen, School of Medicine, Department of Neurology, Los Angeles, CA, USA.
¹⁶ Cedars Sinai Medical Center, Department of Psychiatry, Los Angeles, CA, USA.
¹⁷ University of California, Irvine, School of Medicine, Department of Medicine, Irvine, CA, USA.
¹⁸ Cedars Sinai Medical Center, Spine Institute, Los Angeles, CA, USA.
¹⁹ Cedars-Sinai Medical Center, Department of Neurosurgery, Los Angeles, CA, USA.
²⁰ Cedars-Sinai Medical Center, Department of Cardiology, Los Angeles, CA, USA.
²¹ Cedars-Sinai Medical Center, Department of Nephrology, Los Angeles, CA, USA.
²² Cedars-Sinai Medical Center, Department of Neurology, Los Angeles, CA, USA.
²³ University of Tehran School of Medicine, Department of Cardiology, Tehran, Iran.
²⁴ Loma Linda University, Department of Neurosurgery, Loma Linda, CA, USA.
²⁵ Lafayette Surgical Specialty Hospital, Lafayette, Louisiana, USA.
²⁶ Stanford University School of Medicine (Affiliated), Department of Psychiatry and Behavioral Science and Department of Veteran's Affair, Palo Alto, CA, USA.
²⁷ USC-Keck School of Medicine, Department of Orthopedic Surgery, Los Angeles, CA, USA.
²⁸ Cedars-Sinai Medical Center, Department of Internal Medicine, Los Angeles, CA, USA.
²⁹ Cedars Sinai Medical Center, Department of Gastroenterology, Los Angeles, CA, USA.
³⁰ Cedars Sinai Medical Center, Pain Management, Los Angeles, CA, USA.
³¹ Cedars Sinai Orthopaedic Center, Department of Orthopedics, Los Angeles, CA, USA.
³² National Center for NanoBioElectronic (NCNBE), Los Angeles, CA, USA.
³³ Brain Technology and Innovation Park, Los Angeles, CA, USA.

PMID: 32925078
PMCID: PMC7592693
DOI: 10.3233/JAD-200831

Abstract

COVID-19 is a severe infectious disease that has claimed >150,000 lives and infected millions in the United States thus far, especially the elderly population. Emerging evidence has shown the virus to cause hemorrhagic and immunologic responses, which impact all organs, including lungs, kidneys, and the brain, as well as extremities. SARS-CoV-2 also affects patients', families', and society's mental health at large. There is growing evidence of re-infection in some patients. The goal of this paper is to provide a comprehensive review of SARS-CoV-2-induced disease, its mechanism of infection, diagnostics, therapeutics, and treatment strategies, while also focusing on less attended aspects by previous studies, including nutritional support, psychological, and rehabilitation of the pandemic and its management. We performed a systematic review of >1,000 articles and included 425 references from online databases, including, PubMed, Google Scholar, and California Baptist University's library. COVID-19 patients go through acute respiratory distress syndrome, cytokine storm, acute hypercoagulable state, and autonomic dysfunction, which must be managed by a multidisciplinary team including nursing, nutrition, and rehabilitation. The elderly population and those who are suffering from Alzheimer's disease and dementia related illnesses seem to be at the higher risk. There are 28 vaccines under development, and new treatment strategies/protocols are being investigated. The future management for COVID-19 should include B-cell and T-cell immunotherapy in combination with emerging prophylaxis. The mental health and illness aspect of COVID-19 are among the most important side effects of this pandemic which requires a national plan for prevention, diagnosis and treatment.

Keywords: Actemra; Alzheimer’s disease; Avigan; COVID-19; COVID-19 Neurological implications; COVID-19 Alzheimer’s Disease and dementia; COVID-19 Clinical manifestations; COVID-19 Convalescent plasma; COVID-19 Janus Kinase Inhibitor 1 and 2; COVID-19 Natural Killer Cells and stem cell therapy; COVID-19 Nutrition; COVID-19 Rehabilitation; COVID-19 Risk factors and comorbidities; COVID-19 Screening; COVID-19 Steroids; COVID-19 Vaccines; COVID-19 air filtration; COVID-19 anticoagulants; COVID-19 antiviral; COVID-19 complications; COVID-19 diagnostics; COVID-19 domestic abuse; COVID-19 immunotherapy; COVID-19 mental disorders; COVID-19 monoclonal antibodies; COVID-19 ophthalmology; COVID-19 test; Hydroxychloroquine; Nanomedicine for COVID-19; Remdesivir; SARS-CoV-2; SARS-CoV-2 treatment; coronavirus; mental health.

PubMed Disclaimer

Conflict of interest statement

Authors’ disclosures available online (https://www.j-alz.com/manuscript-disclosures/20-0831r2).

Figures

**Fig.1**
Illustration of COVID-19 Structure. Adapted from the CDC images library [27] and Encyclopedia Britannica [28]. *Illustrated by Dr. Joe Bolanos*.

**Fig.2**
Illustration SARS-CoV Protein E. Adapted from [15]. *Illustrated by Dr. Joe Bolanos*.

**Fig.3**
Distribution of COVID-19 Worldwide distribution. Adapted from the GISAID Genomic Epidemiology of hCoV-19. Last updated 07-24-2020 https://nextstrain.org/ncov/global/gisaid?c=GISAID_clade&p=full [35]. *Illustrated by Dr. Joe Bolanos*.

**Fig.4**
Most common COVID-19 symptoms in US and China. Most common laboratory findings in COVID-19 in China [31, 43–45]. *Illustrated by Dr. Joe Bolanos*.

**Graph 1**
Hospitalizations and Fatalities in COVID-19 patients in Wuhan, China [43].

**Graph 2**
Hospitalizations and Fatalities in COVID-19 patients in the US [3].

**Fig.5**
Schematic illustration of anti COVID-19 medications’ mechanisms of action. *Illustrated by Dr. Babak Kateb*.

See this image and copyright information in PMC

References

1. World Health Organization, Coronavirus disease (COVID-19) Situation Report – 191, https://www.who.int/docs/default-source/coronaviruse/situation-reports/2..., Last Update 29 July 2020, Accessed 29 July 2020.
1. He F, Deng Y, Li W (2020) Coronavirus disease 2019 (COVID-19): What we know? J Med Virol 92, 719–725. - PMC - PubMed
1. CDC, Demographic Trends of COVID-19 cases and deaths in the US reported to CDC, https://www.cdc.gov/covid-data-tracker/#demographics, Last Update 27 June 2020, Accessed 27 June 2020.
1. CDC, Characteristics of Persons Who Died with COVID-19 — United States, February 12–May 18, 2020, Last Update 17 July 2020, Accessed 27 July 2020. - PubMed
1. Heald-Sargent T, Muller WJ, Zheng X, Rippe J, Patel AB, Kociolek LK (2020) Age-related differences in nasopharyngeal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) levels in patients with mild to moderate coronavirus disease 2019 (COVID-19), JAMA Pediatr, doi: 10.1001/jamapediatrics.2020.3651 - DOI - PMC - PubMed

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COVID-19: Review of a 21st Century Pandemic from Etiology to Neuro-psychiatric Implications

Affiliations

COVID-19: Review of a 21st Century Pandemic from Etiology to Neuro-psychiatric Implications

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Miscellaneous