The psychiatric and neuropsychiatric repercussions associated with severe infections of COVID-19 and other coronaviruses

Abstract

Introduction: It is known that viral infections are epidemiologically prevalent and some of them are harmful to the central nervous system (CNS) due to the development of neuropsychiatric syndromes which affect the cognitive, affective, behavioral and perceptual domains.

Objective: To carry out a comprehensive analysis of the psychiatric and neuropsychiatric repercussions of COVID-19 based on epidemiological, pathophysiological and clinical foundations observed in previous and recent pandemic events, and also to make a proposition about effective therapeutic interventions to help tackle this serious public health problem, more specifically in its neuropsychiatric developments.

Method: This current literature review has utilized literature reserves and scientific search engines MEDLINE, EMBASE and Web of Science. The search terms included, "SARS-CoV-2", "etiology," "psychiatric and neuropsychiatric repercussions", "severe infections" "COVID-19". Specific choices of unique papers from each of the searches were identified. The inclusion criteria were relevance and availability of full-text. Papers were excluded on the basis of relevance and non-availability of full-text. Papers were identified in the general literature reserve as pertinent to the search terms.

Results: The main psychiatric and neuropsychiatric repercussions analyzed were depression, anxiety, post-traumatic stress disorder, psychosis, nonspecific neurological symptoms, delirium, cerebrovascular complications, encephalopathies, neuromuscular disorders, anosmia and ageusia.

Conclusion: The psychiatric and neuropsychiatric symptoms of acute respiratory syndromes can appear during or after the infectious stage. Among the risk factors pointed out for such effects are the female gender, health professionals, presence of avascular necrosis and distressing pain.

Keywords: COVID-19; Etiology; Psychiatric and neuropsychiatric repercussions; SARS-CoV-2; Severe infections.

Graphical abstract

Fig. 1

Entry of SARS-CoV-2 into the Nervous System. (1. The virus is recognized by the ACE2, invades a blood-brain barrier reaches the 2. oligodendrocyte that leads to the 3. neurons. Source: Authors (2020).

Fig. 2

The triggering of the cytokine strom. (Source: Authors)

Fig. 3

Molecular components of the cytokine strom. (Source: Authors)

Fig. 4

Main neuropsychiatric repercussions. (Source: Authors)

Fig. 5

Main psychiatric repercussions. (Source: Authors)

Fig. 6

Summary table for therapeutic interventions. (Source: Authors)