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COVID-19 Outbreak May Bring Significant Neuropsychiatric Burden

April 22, 2020

The neuropsychiatric burden of the COVID-19 pandemic is likely to be significant, warns a paper published online in the journal Brain, Behavior, and Immunity. 

“Past pandemics have demonstrated that diverse types of neuropsychiatric symptoms, such as encephalopathy, mood changes, psychosis, neuromuscular dysfunction or demyelinating processes, may accompany acute viral infection, or may follow infection by weeks, months, or longer in recovered patients,” wrote senior author Suzi Hong, PhD, and coauthors Emily Troyer, MD, and Jordan Kohn, PhD, from the University of California San Diego School of Medicine.

Consequently, the researchers call for longitudinal monitoring of COVID-19 patients throughout their lifetime to understand the direct impact of the SARS-CoV-2 virus, which causes COVID-19, on the brain and behavior.

Following influenza pandemics in the 18th and 19th centuries, reports of neuropsychiatric symptoms such as insomnia, anxiety, depression, mania, suicidality, and delirium increased, researchers noted. Meanwhile, more recent viral outbreaks, including SARS-CoV-1 in 2003, H1N1 in 2009, and MERS-CoV in 2012, coincided with increased reports of narcolepsy, seizures, encephalitis, Guillain-Barre syndrome, and other neuromuscular and demyelinating conditions.

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“Reports are already surfacing of acute central nervous system-associated symptoms in individuals affected by COVID-19,” said Dr. Hong, such as increased incidence of stroke in severely infected patients in Wuhan, China. Delirium and diminished smell and taste, too, have been reported.

Although currently unknown, the neuropsychiatric consequences of COVID-19 will likely be substantial and last years, according to the article. Researchers urged long-term monitoring of people exposed to SARS-CoV-2, including individuals exposed in utero, to better understand and mitigate the effects of the virus.

“We will need to do this at different points in their lives, for years to come, to fully appreciate this pandemic’s effects on neuropsychiatric outcomes for differing age groups,” said Dr. Hong, “and how to better prepare for pandemics to come.”

—Jolynn Tumolo

References 

Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain, Behavior, and Immunity. 2020 April 13;[Epub ahead of print].

LaFee S. In wake of COVID-19 pandemic, a crashing wave of neuropsychiatric problems? [press release]. San Diego, California: UC San Diego Health; April 14, 2020.

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