Biological and Psychological Factors Determining Neuropsychiatric Outcomes in COVID-19.
Boris N TizenbergLisa A BrennerChristopher A LowryOlaoluwa O OkusagaDavid R BenavidesAndrew J HoisingtonMichael E BenrosJohn W StillerRonald C KesslerTeodor Tudorel PostolachePublished in: Current psychiatry reports (2021)
Preexisting mental illness leads to worse clinical outcomes in COVID-19. The presence of the virus was reported in the cerebrospinal fluid (CSF) and brain tissue post-mortem. Most common psychiatric manifestations include delirium, mood disorders, anxiety disorders, and posttraumatic stress disorder. "Long-COVID" non-syndromal presentations include "brain-fogginess," autonomic instability, fatigue, and insomnia. SARS-CoV-2 infection can trigger prior vulnerabilities based on the priming of microglia and other cells, induced or perpetuated by aging and mental and physical illnesses. COVID-19 could further induce priming of neuroimmunological substrates leading to exacerbated immune response and autoimmunity targeting structures in the central nervous system (CNS), in response to minor immune activating environmental exposures, including stress, minor infections, allergens, pollutants, and traumatic brain injury.
Keyphrases
- coronavirus disease
- sars cov
- mental health
- mental illness
- cerebrospinal fluid
- traumatic brain injury
- posttraumatic stress disorder
- respiratory syndrome coronavirus
- immune response
- sleep quality
- white matter
- resting state
- induced apoptosis
- skeletal muscle
- bipolar disorder
- oxidative stress
- inflammatory response
- multiple sclerosis
- cell proliferation
- high glucose
- mass spectrometry
- blood pressure
- spinal cord injury
- depressive symptoms
- toll like receptor
- blood brain barrier
- brain injury
- adipose tissue
- risk assessment
- cancer therapy
- endoplasmic reticulum stress
- endothelial cells
- neuropathic pain
- subarachnoid hemorrhage
- diabetic rats