Viral respiratory infections and psychosis: A review of the literature and the implications of COVID-19

Exacerbation of psychosis risk during the COVID-19 pandemic: The disproportionate impact on the lower income population

“…Second, post viral exposure psychosis has been reported since the Spanish flu, with acute “psychoses of influenza” being documented during multiple pandemics ( Kępińska et al, 2020 ). This is not different for the COVID pandemic, and several cases of new-onset psychosis after coronavirus infection were described up until now ( Alba et al, 2021 ; D′Agostino et al, 2021 ; Parker et al, 2021 ), reinforcing the hypothesis of the viral origin of schizophrenia ( DeLisi, 2021 ; Kulaga and Miller, 2021 ).…”

COVID-19 Induced Brief Psychotic Disorder: A Case Report and Review of Literature

“…Coronaviruses are regarded as neurotropic and can enter the brain, therefore triggering an inflammatory response [ 6 ], resulting in release of inflammatory cytokines like IL-6, TNF- α , and IL-1 β that have been found in patients with first episode psychosis [ 7 ], which may be the reason for the psychosis seen here. The virus is thought to enter the central nervous system (CNS) via the hematogenous route or peripheral neurons, relying on retrograde axonal transport after which it binds to the angiotensin-converting enzyme 2 (ACE2), the cell entry receptor on both neurons and glia [ 8 ]. Though the overall levels of this receptor within the CNS are low compared to other organs (for example, the lungs), it is still implicated within the pathogenesis for the neuropsychiatric symptoms in patients with coronavirus [ 8 ].…”

“…The virus is thought to enter the central nervous system (CNS) via the hematogenous route or peripheral neurons, relying on retrograde axonal transport after which it binds to the angiotensin-converting enzyme 2 (ACE2), the cell entry receptor on both neurons and glia [ 8 ]. Though the overall levels of this receptor within the CNS are low compared to other organs (for example, the lungs), it is still implicated within the pathogenesis for the neuropsychiatric symptoms in patients with coronavirus [ 8 ]. Within the CNS, the overall expression of ACE2 receptors is relatively high in dopaminergic and serotonergic nuclei, glutamatergic neurons, lateral ventricles, and the substantia nigra, which are areas that are implicated in schizophrenia [ 8 ].…”

“…Though the overall levels of this receptor within the CNS are low compared to other organs (for example, the lungs), it is still implicated within the pathogenesis for the neuropsychiatric symptoms in patients with coronavirus [ 8 ]. Within the CNS, the overall expression of ACE2 receptors is relatively high in dopaminergic and serotonergic nuclei, glutamatergic neurons, lateral ventricles, and the substantia nigra, which are areas that are implicated in schizophrenia [ 8 ]. One possible hypothesis is that these areas, due to their relatively high concentration of the ACE2 receptors, are more vulnerable to the virus, which may shape the neuropsychiatric symptoms we see in COVID-19 patients [ 8 ].…”

COVID-19-associated psychosis: A systematic review of case reports

“…Psychosis has been associated with pandemic respiratory viruses for centuries [ 8 ]. A rapid review of the literature identified incident cases of psychosis linked to an infection with SARS, MERS, and influenza (H1N1) in 0.9% to 4% of infections [ 9 ].…”