Neuropsychiatric Disorders and COVID-19: What We Know So Far

Majolo, Fernanda; Silva, Guilherme Liberato da; Vieira, Lucas Pacheco; Anli, Cetin; Timmers, Luís Fernando Saraiva Macedo; Laufer, Stefan; Goettert, Márcia Inês

doi:10.3390/ph14090933

Cited by 13 publications

(12 citation statements)

References 149 publications

(203 reference statements)

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“…Fifteen percent of patients presented neuro-psychiatric symptoms requiring treatment. These disorders are well-described in the literature and could be linked to a direct action of the virus on the nervous system [38,39].…”

Section: Discussionmentioning

confidence: 94%

Long-Term Evolution of Malnutrition and Loss of Muscle Strength after COVID-19: A Major and Neglected Component of Long COVID-19

et al. 2021

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Post-acute consequences of COVID-19, also termed long COVID, include signs and symptoms persisting for more than 12 weeks with prolonged multisystem involvement; most often, however, malnutrition is ignored. Method: The objective was to analyze persistent symptoms, nutritional status, the evolution of muscle strength and performance status (PS) at 6 months post-discharge in a cohort of COVID-19 survivors. Results: Of 549 consecutive patients hospitalized for COVID-19 between 1 March and 29 April 2020, 23.7% died and 288 patients were at home at D30 post-discharge. At this date, 136 of them (47.2%) presented persistent malnutrition, a significant decrease in muscle strength or a PS ≥ 2. These patients received dietary counseling, nutritional supplementation, adapted physical activity guidance or physiotherapy assistance, or were admitted to post-care facilities. At 6 months post-discharge, 91.0% of the 136 patients (n = 119) were evaluated and 36.0% had persistent malnutrition, 14.3% complained of a significant decrease in muscle strength and 14.9% had a performance status > 2. Obesity was more frequent in patients with impairment than in those without (52.8% vs. 31.0%; p = 0.0071), with these patients being admitted more frequently to ICUs (50.9% vs. 31.3%; p = 0.010). Among those with persistent symptoms, 10% had psychiatric co-morbidities (mood disorders, anxiety, or post-traumatic stress syndrome), 7.6% had prolonged pneumological symptoms and 4.2% had neurological symptoms. Conclusions: Obese subjects as well as patients who have stayed in intensive care have a higher risk of functional loss or undernutrition 6 months after a severe COVID infection. Malnutrition and loss of muscle strength should be considered in the clinical assessment of these patients.

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Section: Discussionmentioning

confidence: 94%

Long-Term Evolution of Malnutrition and Loss of Muscle Strength after COVID-19: A Major and Neglected Component of Long COVID-19

et al. 2021

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“…However, direct neuroinvasion as a cause of seizure is currently controversial, with a number of studies failing to find viral RNA in CSF. Elevated levels of inflammatory cytokines, including IL-6, IL-1β, and TNF-α, have been found in patients following acute febrile seizures and a dysregulated cytokine surge in response to COVID-19 infection has been proposed as a possible etiology of seizure [1].…”

Section: Seizurementioning

confidence: 99%

“…While many COVID-19 patients may exhibit mild neurologic symptoms, a small percentage of patients can develop severe neurologic disorders [1]. Soon after the discovery of the illness, and the World Health Organization declaring COVID-19 a global pandemic, clinicians began reporting delirium and encephalitis in acutely ill patients with confirmed infection [2], and early retrospective studies coming out of China [3] and France [4] indicated that significant proportions of patients were experiencing neurologic complications during COVID-19 hospitalization.…”

Section: Introductionmentioning

confidence: 99%

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Neurological Sequelae of COVID-19

Ahmad¹,

Feigen²,

Vazquez³

et al. 2022

J. Integr. Neurosci.

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Background: Though primarily a pulmonary disease, Coronavirus disease 2019 caused by the SARS-CoV-2 virus can generate devastating disease states that affect multiple organ systems including the central nervous system (CNS). The various neurological disorders associated with COVID-19 range in severity from mild symptoms such as headache, or myalgias to more severe symptoms such as stroke, psychosis, and anosmia. While some of the COVID-19 associated neurological complications are mild and reversible, a significant number of patients suffer from stroke. Studies have shown that COVID-19 infection triggers a wave of inflammatory cytokines that induce endothelial cell dysfunction and generate coagulopathy that increases the risk of stroke or thromboses. Inflammation of the endothelium following infection may also destabilize atherosclerotic plaque and induce thrombotic stroke. Although uncommon, there have also been reports of hemorrhagic stroke associated with COVID-19. The proposed mechanisms include a blood pressure increase caused by infection leading to a reduction in angiotensin converting enzyme-2 (ACE-2) levels that results in an imbalance of the renin-angiotensin system ultimately manifesting inflammation and vasoconstriction. Coagulopathy, as demonstrated by elevated prothrombin time (PT), has also been posited as a factor contributing to hemorrhagics stroke in patients with COVID-19. Other neurological conditions associated with COVID-19 include encephalopathy, anosmia, encephalitis, psychosis, brain fog, headache, depression, and anxiety. Though there are several hypotheses reported in the literature, a unifying pathophysiological mechanism of many of these disorders remains unclear. Pulmonary dysfunction leading to poor oxygenation of the brain may explain encephalopathy and other disorders in COVID-19 patients. Alternatively, a direct invasion of the CNS by the virus or breach of the blood-brain barrier by the systemic cytokines released during infection may be responsible for these conditions. Notwithstanding, the relationship between the inflammatory cytokine levels and conditions such as depression and anxiety is contradictory and perhaps the social isolation during the pandemic may in part be a contributing factor to some of the reported CNS disorders. Objective: In this article, we review the current literature pertaining to some of the most significant and common neurological disorders such as ischemic and hemorrhagic stroke, encephalopathy, encephalitis, brain fog, Long COVID, headache, Guillain-Barre syndrome, depression, anxiety, and sleep disorders in the setting of COVID-19. We summarize some of the most relevant literature to provide a better understanding of the mechanistic details regarding these disorders in order to help physicians monitor and treat patients for significant COVID-19 associated neurologic impairments. Methods: A literature review was carried out by the authors using PubMed with the search terms "COVID-19" and "Neurology", "Neurological Manifestations", "Neuropsychiatric ...

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“…Therefore, the fundamental mechanism of neuropsychiatric disorders in COVID-19 might be due to cytokine-induced disruption of the BBB, neuroinflammation, and peripheral neuronal injury, or due to direct SARS-CoV-2 neurotropism (Majolo et al 2021 ). Noteworthily , exaggerated inflammatory responses could be the suggested mechanism for the progression of neuropsychiatric and other neurological disorders in COVID-19 (Kumar et al 2021 ).…”

Section: Covid-19 and Neurological Manifestationsmentioning

confidence: 99%

Citicoline and COVID-19: vis-à-vis conjectured

Al-Kuraishy

Al-Buhadily

Al-Gareeb

et al. 2022

Naunyn-Schmiedeberg's Arch Pharmacol

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Coronavirus disease 2019 (COVID-19) is a current pandemic disease caused by a novel severe acute respiratory syndrome coronavirus virus respiratory type 2 (SARS-CoV-2). SARS-CoV-2 infection is linked with various neurological manifestations due to cytokine-induced disruption of the blood brain barrier (BBB), neuroinflammation, and peripheral neuronal injury, or due to direct SARS-CoV-2 neurotropism. Of note, many repurposed agents were included in different therapeutic protocols in the management of COVID-19. These agents did not produce an effective therapeutic eradication of SARS-CoV-2, and continuing searching for novel anti-SARS-CoV-2 agents is a type of challenge nowadays. Therefore, this study aimed to review the potential anti-inflammatory and antioxidant effects of citicoline in the management of COVID-19.

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Neuropsychiatric Disorders and COVID-19: What We Know So Far

Cited by 13 publications

References 149 publications

Long-Term Evolution of Malnutrition and Loss of Muscle Strength after COVID-19: A Major and Neglected Component of Long COVID-19

Long-Term Evolution of Malnutrition and Loss of Muscle Strength after COVID-19: A Major and Neglected Component of Long COVID-19

Neurological Sequelae of COVID-19

Citicoline and COVID-19: vis-à-vis conjectured

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