Neuropsychiatric Complications of COVID-19

Abstract

Purpose of Review To describe the presentation, etiologies, and suggested management of post-acute COVID-19 neuropsychiatric symptoms. Recent Findings Over 30% of patients hospitalized with COVID-19 may exhibit cognitive impairment, depression, and anxiety that persist for months after discharge. These symptoms are even more common in patients who required intensive care for severe effects of the virus. In addition to the pandemic-related psychological stress, multiple biological mechanisms have been proposed to understand the neuropsychiatric symptoms observed with COVID-19. Given limited research regarding effective interventions, we recommend pharmacologic and behavioral strategies with established evidence in other medically-ill populations. Summary Long-term, neuropsychiatric complications of COVID-19 are common and consequential. Because these are likely to co-occur with other medical problems, patients recovering from COVID-19 are best managed in clinics with highly coordinated care across disciplines and medical specialties. Future research is needed to inform appropriate interventions.

Epidemiology and organ specific sequelae of post-acute COVID19: A narrative review

“…For example, the isolation and lack of ability of family to visit hospitalized patients with acute COVID-19, could amplify feelings of depression and PTSD post discharge. Eighteen to 50% of SARS-CoV-2 survivors screen positive in at least one of the neuropsychiatric domains evaluated in cross-sectional and cohort studies, both in the sub-acute and more long-term setting [173][174][175].…”

Mental health and quality of life in COVID‐19 survivors: A needed discussion

“…It is believed that SARS-CoV-1 and MERS-CoV can infect the central nervous system, in particular the brain stem [2]. The mechanisms for developing symptoms indicate that it is a combination of biological and environmental factors, as well as immunological reactions that affect the bloodbrain barrier and provoke coagulopathies, such as strokes, with delirium being one of the most common manifestations [2].…”

“…It is believed that SARS-CoV-1 and MERS-CoV can infect the central nervous system, in particular the brain stem [2]. The mechanisms for developing symptoms indicate that it is a combination of biological and environmental factors, as well as immunological reactions that affect the bloodbrain barrier and provoke coagulopathies, such as strokes, with delirium being one of the most common manifestations [2]. Delirium and the need for intensive care cause Post-traumatic stress disorder (PTSD) in 20% of survivors in general [2]; these data are also proven by the analyzed article [1], as 25.1% tested positive for this condition.…”

“…The mechanisms for developing symptoms indicate that it is a combination of biological and environmental factors, as well as immunological reactions that affect the bloodbrain barrier and provoke coagulopathies, such as strokes, with delirium being one of the most common manifestations [2]. Delirium and the need for intensive care cause Post-traumatic stress disorder (PTSD) in 20% of survivors in general [2]; these data are also proven by the analyzed article [1], as 25.1% tested positive for this condition. It is interesting to note that risk factors for COVID-19 are also related to PTSD, such as obesity, diabetes, and cardiovascular diseases [2], which may further explain the symptomatology in post-COVID patients and the need for adequate treatment.…”

Prevalence of Risk Factors Associated With Mental Health Symptoms Among the Outpatient Psychiatric Patients and Their Family Members in China During the Coronavirus Disease 2019 Pandemic

“…Following the timely response, the current status of prevention and control in China has become relatively stable, and even places with a high risk of infection, such as hospitals, have also reopened and restored their functions under strict quarantine rules. The COVID-19 pandemic has increased the risk of mental illness, such as anxiety, depression, and other mental disorders, as well as changed people's daily routines, including sleep, exercise, work, or medical treatment (Khan et al, 2021 ; Nakamura et al, 2021 ). During the early stages of the COVID-19 epidemic, global attention was mainly focused on infected patients, frontline medical staff and populations in some special stages.…”