Prenatal exposure to viral infection and neuropsychiatric disorders in offspring: A review of the literature and recommendations for the COVID-19 pandemic

Abstract

The SARS-CoV-2 virus has emerged as a striking 21st century pandemic. Communities across the globe have experienced significant infection rates and widespread psychosocial stress and trauma, leading to calls for increased allocation of resources for mental health screening and treatment. In addition to the burden of psychosocial stress, there is increasing evidence of direct viral neuroinvasion of the central nervous system through physical contact with the nasal mucosa. In a parallel fashion, there is a significant body of ongoing research related to the risk of in utero viral transmission and the resulting neurodevelopmental impact in the fetus. Aberrant neurodevelopment secondary to viral transmission has previously been related to the later development of psychosis, schizophrenia, and schizophrenia spectrum disorders, generating the hypothesis that this population of individuals exposed to SARS-CoV-2 may see an increased incidence in future decades. We discuss the current understanding of the possible neurotropism and vertical transmission of SARS-CoV-2, and relate this to the history of viral pandemics to better understand the relationship of viral infection, aberrant immune response and neurodevelopment, and the risk for schizophrenia disorder.

Repurposing of CNS drugs to treat COVID-19 infection: targeting the sigma-1 receptor

“…Accumulating evidence suggests that SARS-CoV-2 infection has deleterious effects in the central nervous system (CNS), which can result in psychiatric and neurological symptoms in infected individuals [ 9 – 13 ]. In addition, the risk for neurodevelopmental disorders such as autism spectrum disorder in offspring of COVID19-infected pregnant women has been discussed [ 14 , 15 ].…”

Early or Late Gestational Exposure to Maternal Immune Activation Alters Neurodevelopmental Trajectories in Mice: An Integrated Neuroimaging, Behavioral, and Transcriptional Study

“…The effects of MIA are complex and may differ between regions, so whole brain strategies prioritizing developmental trajectories are particularly relevant in furthering our understanding of MIA-impact and moving beyond the many previous studies that have focused on isolated brain regions or behaviours in adulthood (16,25). Furthermore, given the current COVID-19 global crisis, gaining an understanding of the long term effects of MIA is critical, as the number of MIA-exposed offspring is expected to rise (32)(33)(34).…”

SARS-CoV-2 Infection in Pregnant Women: Neuroimmune-Endocrine Changes at the Maternal-Fetal Interface

“…Maternal infections by viruses have been extensively reported to lead to several neuropsychiatric outcomes (e.g., psychosis, depression, anxiety, schizophrenia spectrum disorders, cognitive deficits, and sensory-motor deficits) [ 146 ]. Furthermore, abnormal levels of inflammatory mediators [ 147 , 148 ] and steroid hormones [ 149 ] after prenatal infections can lead to disruption in fetal development.…”