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World J Psychiatr. Jul 19, 2021; 11(7): 347-354
Published online Jul 19, 2021. doi: 10.5498/wjp.v11.i7.347
Impact of SARS-CoV-2 on neuropsychiatric disorders
Maria Angeles Robinson-Agramonte, Carlos-Alberto Gonçalves, Elena Noris-García, Naybí Préndes Rivero, Anna Lisa Brigida, Stephen Schultz, Dario Siniscalco, Ramiro Jorge García García
Maria Angeles Robinson-Agramonte, Neuroimmunology Department, Research Center, International Center for Neurological Restoration, Havana 11300, Cuba
Carlos-Alberto Gonçalves, Department of Biochemistry, Federal University of Rio Grande do Sul, Porto Alegre 90040-060, Brazil
Elena Noris-García, Immunology Department, National Institute of Nephrology, Havana 10600, Cuba
Naybí Préndes Rivero, Department of Mental Health, San Antonio de los Baños Hospital, Havana 38100, Cuba
Anna Lisa Brigida, Department of Mental and Physical Health and Preventive Medicine, University of Campania, Naples 80138, Italy
Stephen Schultz, Department of Cellular and Integrative Physiology, School of Medicine, University of Texas Health San Antonio, San Antonio, TX 78229, United States
Dario Siniscalco, Department of Experimental Medicine, University of Campania, Naples 80138, Italy
Ramiro Jorge García García, Children Hospital “Juan Manuel Márquez”, Havana 11500, Cuba
Author contributions: All authors listed made a substantial, direct and intellectual contribution to the work, and approved it for publication. Robinson-Agramonte MA organized and planned the manuscript; Robinson-Agramonte MA, Prendes N and Noris E wrote the paper; Siniscalco D drafted and revised the manuscript; Goncalves CA and García García critically revised the manuscript; Brigida AL searched and provided the references, Schultz S edited and corrected the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maria de los Angeles Robinson-Agramonte, MD, Professor, Neuroimmunology Department, Research Center, International Center for Neurological Restoration, Ave 25 # 15805 e/n 158 y 160, Havana 11300, Cuba. neuromary2018@gmail.com
Received: February 11, 2021
Peer-review started: February 11, 2021
First decision: March 16, 2021
Revised: March 18, 2021
Accepted: May 24, 2021
Article in press: May 24, 2021
Published online: July 19, 2021
Processing time: 153 Days and 22.8 Hours
Abstract

Evolving data show a variable expression of clinical neurological manifestations in patients suffering with coronavirus disease 2019 (COVID-19) from early disease onset. The most frequent symptoms and signs are fatigue, dizziness, impaired consciousness, ageusia, anosmia, radicular pain, and headache, as well as others. Based on the high number of series of cases reported, there is evidence for the implication of the immune system in the pathological mechanism of COVID-19. Although the exact role of the immunological mechanism is not elucidated, two main mechanisms are suggested which implicate the direct effect of severe acute respiratory syndrome coronavirus 2 infection in the central nervous system and neuroinflammation. In the context of neurological manifestations associated with COVID-19, neuropsychiatric disorders show an exacerbation and are described by symptoms and signs such as depression, anxiety, mood alterations, psychosis, post-traumatic stress disorder, delirium, and cognitive impairment, which appear to be common in COVID-19 survivors. A worsened score on psychopathological measures is seen in those with a history of psychiatric comorbidities. We review the neuropsychiatric manifestations associated with COVID-19 and some critical aspects of the innate and adaptive immune system involved in mental health disorders occurring in COVID-19.

Keywords: COVID-19; Immunological mechanism; Neuropsychiatric manifestation; Cytokine storm; Adaptive immune response; Innate immune response

Core Tip: Severe acute respiratory syndrome coronavirus 2 infects the central nervous system and drives neuroinflammation. In coronavirus disease 2019 (COVID-19) patients, neuropsychiatric disorders are showing an exacerbation and are described by symptoms and signs such as depression, anxiety, mood alterations, psychosis, post-traumatic stress disorder, delirium, and cognitive impairments. Some critical aspects of the innate and adaptive immune system are also involved in mental health disorders occurring in COVID-19.