da Silva Júnior RT, Santos Apolonio J, Cuzzuol BR, da Costa BT, Silva CS, Araújo GRL, Silva Luz M, Marques HS, Santos LKS, Pinheiro SLR, Lima de Souza Gonçalves V, Calmon MS, Freire de Melo F. COVID-19 neuropsychiatric repercussions: Current evidence on the subject. World J Methodol 2022; 12(5): 365-380 [PMID: 36186752 DOI: 10.5662/wjm.v12.i5.365]
Corresponding Author of This Article
Fabrício Freire de Melo, MSc, PhD, Postdoc, Professor, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Rua Hormindo Barros, 58, Vitória da Conquista 45029094, Brazil. freiremelo@yahoo.com.br
Research Domain of This Article
Medicine, General & Internal
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
World J Methodol. Sep 20, 2022; 12(5): 365-380 Published online Sep 20, 2022. doi: 10.5662/wjm.v12.i5.365
COVID-19 neuropsychiatric repercussions: Current evidence on the subject
Ronaldo Teixeira da Silva Júnior, Jonathan Santos Apolonio, Beatriz Rocha Cuzzuol, Bruna Teixeira da Costa, Camilo Santana Silva, Glauber Rocha Lima Araújo, Marcel Silva Luz, Hanna Santos Marques, Luana Kauany de Sá Santos, Samuel Luca Rocha Pinheiro, Vinícius Lima de Souza Gonçalves, Mariana Santos Calmon, Fabrício Freire de Melo
Ronaldo Teixeira da Silva Júnior, Jonathan Santos Apolonio, Beatriz Rocha Cuzzuol, Bruna Teixeira da Costa, Camilo Santana Silva, Glauber Rocha Lima Araújo, Marcel Silva Luz, Luana Kauany de Sá Santos, Samuel Luca Rocha Pinheiro, Mariana Santos Calmon, Fabrício Freire de Melo, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029094, Brazil
Hanna Santos Marques, Vinícius Lima de Souza Gonçalves, Universidade Estadual do Sudoeste da Bahia, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista 45083900, Brazil
Author contributions: All authors equally contributed to this paper regarding the conception and design of the study, literature review and analysis, drafting and critical revision and editing, and final approval of the final version.
Conflict-of-interest statement: The authors have no conflicts to declare.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fabrício Freire de Melo, MSc, PhD, Postdoc, Professor, Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Rua Hormindo Barros, 58, Vitória da Conquista 45029094, Brazil. freiremelo@yahoo.com.br
Received: February 28, 2022 Peer-review started: February 28, 2022 First decision: June 16, 2022 Revised: June 30, 2022 Accepted: July 25, 2022 Article in press: July 25, 2022 Published online: September 20, 2022
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected the entire world, causing the coronavirus disease 2019 (COVID-19) pandemic since it was first discovered in Wuhan, China in December 2019. Among the clinical presentation of the disease, in addition to fever, fatigue, cough, dyspnea, diarrhea, nausea, vomiting, and abdominal pain, infected patients may also experience neurological and psychiatric repercussions during the course of the disease and as a post-COVID-19 sequelae. Thus, headache, dizziness, olfactory and gustatory dysfunction, cerebrovascular disorders, neuromuscular abnormalities, anxiety, depression, and post-traumatic stress disorder can occur both from the infection itself and from social distancing and quarantine. According to current evidence about this infection, the virus has the ability to infect the central nervous system (CNS) via angiotensin-converting enzyme 2 (ACE2) receptors on host cells. Several studies have shown the presence of ACE2 in nerve cells and nasal mucosa, as well as transmembrane serine protease 2, key points for interaction with the viral Spike glycoprotein and entry into the CNS, being olfactory tract and blood-brain barrier, through hematogenous dissemination, potential pathways. Thus, the presence of SARS-CoV-2 in the CNS supports the development of neuropsychiatric symptoms. The management of these manifestations seems more complex, given that the dense parenchyma and impermeability of brain tissue, despite protecting the brain from the infectious process, may hinder virus elimination. Still, some alternatives used in non-COVID-19 situations may lead to worse prognosis of acute respiratory syndrome, requiring caution. Therefore, the aim of this review is to bring more current points related to this infection in the CNS, as well as the repercussions of the isolation involved by the pandemic and to present perspectives on interventions in this scenario.
Core Tip: Severe acute respiratory syndrome coronavirus 2 infection may also involve neurological and psychiatric manifestations, both by the viral action itself and by social distancing and quarantine. Headache, dizziness, cerebrovascular disorders, olfactory and gustatory dysfunction, neuromuscular abnormalities, anxiety, depression, and post-traumatic stress disorder may occur in this setting. Supporting these repercussions, this virus is able to reach the central nervous system by the interaction between the angiotensin-converting enzyme 2 and the transmembrane protease serine 2 expressed in the host nerve cells, and the viral spike glycoprotein. Finally, the management of these patients is complex and we review current evidence on the subject.
