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. 2022 Jan 12;25(1):1-12.
doi: 10.1093/ijnp/pyab069.

SARS-CoV-2 Psychiatric Sequelae: A Review of Neuroendocrine Mechanisms and Therapeutic Strategies

Mary G Hornick  1 , Margaret E Olson  1 , Arun L Jadhav  1
Affiliations

SARS-CoV-2 Psychiatric Sequelae: A Review of Neuroendocrine Mechanisms and Therapeutic Strategies

Mary G Hornick et al. Int J Neuropsychopharmacol. .

Abstract

From the earliest days of the coronavirus disease 2019 (COVID-19) pandemic, there have been reports of significant neurological and psychological symptoms following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. This narrative review is designed to examine the potential psychoneuroendocrine pathogenic mechanisms by which SARS-CoV-2 elicits psychiatric sequelae as well as to posit potential pharmacologic strategies to address and reverse these pathologies. Following a brief overview of neurological and psychological sequelae from previous viral pandemics, we address mechanisms by which SARS-CoV-2 could enter or otherwise elicit changes in the CNS. We then examine the hypothesis that COVID-19-induced psychiatric disorders result from challenges to the neuroendocrine system, in particular the hypothalamic-pituitary-adrenal stress axis and monoamine synthesis, physiological mechanisms that are only further enhanced by the pandemic-induced social environment of fear, isolation, and socioeconomic pressure. Finally, we evaluate several FDA-approved therapeutics in the context of COVID-19-induced psychoneuroendocrine disorders.

Keywords: COVID-19; neuroendocrine; neuroimmunology; neuropsychiatric disorders; therapeutic strategies.

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Figures

Figure 1.
Figure 1.
Direct (solid line) and indirect (dashed line) mechanisms by which the COVID-19 pandemic has led to an increase in psychological and mood disorders. *Denotes mechanisms discussed in the present manuscript.
Figure 2.
Figure 2.
Potential mechanisms by which SARS-CoV-2 directly (solid lines) and indirectly (dashed lines) alters neuroendocrine pathways leading to psychological and neurological disturbances. *Indicates available therapeutic options that are being studied in conjunction with SARS-CoV-2.
See this image and copyright information in PMC

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