Main neurological and psychiatric manifestations in the context of the COVID-19 pandemic

Authors

DOI:

https://doi.org/10.33448/rsd-v12i14.44563

Keywords:

Pandemic; COVID-19; Neurological deficits; Psychiatric disorders.

Abstract

The investigation into the neurological and psychiatric manifestations of the new coronavirus (COVID-19), identified in Wuhan, China, in 2019. In addition to lung damage, the virus demonstrates the ability to affect other tissues and systems, including the nervous system, becoming lethal due to respiratory failure. The psychiatric disorders associated with the disease also demand attention due to the global emotional impact. The study aims to describe the main neurological and psychiatric manifestations in people infected during the 2020-2022 pandemic. Conducted as a narrative review, 26 scientific articles in Portuguese and English were analyzed from databases such as LILACS, MEDLINE, Portal de Periódicos da CAPES and SCIELO, published between 2019-2021. The findings included anosmia, ageusia, altered mental state and headache. The studies also addressed mental health, highlighting depression, anxiety and post-traumatic stress as the main psychiatric manifestations. The virus is believed to reach the nervous system via receptors such as ACE 2, NRP-1 and BSG/CD147. Severe patients have a high concentration of pro-inflammatory mediators due to excessive activation of the NF-kB complex. The wide range of symptoms highlights the need for in-depth studies to guide more effective therapeutic approaches to the various neurological and psychiatric manifestations associated with COVID-19.

References

Ariza-Varón M et al. (2022). Psychosis associated with suspected SARS-CoV-2 encephalitis with response to steroids: a case report. Infect Dis (Lond). 54(2):152-156. 10.1080/23744235.2021.1977381

Bernheim A. et al. (2020). Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection. Radiology. Jun;295(3):200463. 10.1148/radiol.2020200463

Braga, L. W., Oliveira, S. B., Moreira, A. S., Pereira, M. E., Carneiro, V. S., Serio, A. S., Freitas, L. F., Isidro, H. B. L., & Souza, L. M. N. (2022). Neuropsychological manifestations of long COVID in hospitalized and non-hospitalized Brazilian Patients. NeuroRehabilitation, 50(4), 391–400. https://doi.org/10.3233/NRE-228020

Carod-Artal F. J. (2021). Post-COVID-19 syndrome: epidemiology, diagnostic criteria and pathogenic mechanisms involved. Síndrome post-COVID-19: epidemiología, criterios diagnósticos y mecanismos patogénicos implicados. Revista de neurologia, 72(11), 384–396. https://doi.org/10.33588/rn.7211.2021230

Castillo-Álvarez, F., Fernández-Infante, E., Campos, M. S., & García-Mozún, B. (2022). Sintomatología neuropsiquiátrica en el síndrome post-COVID. Propuesta de manejo y derivación desde atención primaria [Neuropsychiatric symptomatology in post-COVID syndrome. Intervention proposal and referral from primary care]. Semergen, 48(4), 263–274. https://doi.org/10.1016/j.semerg.2021.09.012

Chia, K. X., Polakhare, S., & Bruno, S. D. (2020). Possible affective cognitive cerebellar syndrome in a young patient with COVID-19 CNS vasculopathy and stroke. BMJ case reports, 13(10), e237926. https://doi.org/10.1136/bcr-2020-237926

Crivelli, L., Calandri, I., Corvalán, N., Carello, M. A., Keller, G., Martínez, C., Arruabarrena, M., & Allegri, R. (2022). Cognitive consequences of COVID-19: results of a cohort study from South America. Arquivos de neuro-psiquiatria, 80(3), 240–247. https://doi.org/10.1590/0004-282X-ANP-2021-0320

Davies, D. A., Adlimoghaddam, A., & Albensi, B. C. (2021). The Effect of COVID-19 on NF-κB and Neurological Manifestations of Disease. Molecular neurobiology, 58(8), 4178–4187. https://doi.org/10.1007/s12035-021-02438-2

Del Brutto, O. H., Wu, S., Mera, R. M., Costa, A. F., Recalde, B. Y., & Issa, N. P. (2021). Cognitive decline among individuals with history of mild symptomatic SARS-CoV-2 infection: A longitudinal prospective study nested to a population cohort. European journal of neurology, 28(10), 3245–3253. https://doi.org/10.1111/ene.14775

Delorme, C., Paccoud, O., Kas, A., Hesters, A., Bombois, S., Shambrook, P., Boullet, A., Doukhi, D., Le Guennec, L., Godefroy, N., Maatoug, R., Fossati, P., Millet, B., Navarro, V., Bruneteau, G., Demeret, S., Pourcher, V., & CoCo-Neurosciences study group and COVID SMIT PSL study group (2020). COVID-19-related encephalopathy: a case series with brain FDG-positron-emission tomography/computed tomography findings. European journal of neurology, 27(12), 2651–2657. https://doi.org/10.1111/ene.14478

Faro, A. et al. (2020). COVID-19 e saúde mental: a emergência do cuidado. Estudos de Psicologia (Campinas) [online]. Jun 1;37:e200074. 10.1590/1982-0275202037e200074

García-Azorín, D., Abildúa, M. J. A., Aguirre, M. E. E., Fernández, S. F., Moncó, J. C. G., Guijarro-Castro, C., Platas, M. G., Delgado, F. R., Andrés, J. M. L., Ezpeleta, D., & Spanish neuroCOVID registry group (2021). Neurological presentations of COVID-19: Findings from the Spanish Society of Neurology neuroCOVID-19 registry. Journal of the neurological sciences, 423, 117283. https://doi.org/10.1016/j.jns.2020.117283

Generoso, J. S., Barichello de Quevedo, J. L., Cattani, M., Lodetti, B. F., Sousa, L., Collodel, A., Diaz, A. P., & Dal-Pizzol, F. (2021). Neurobiology of COVID-19: how can the virus affect the brain? Revista brasileira de psiquiatria, 43(6), 650–664. https://doi.org/10.1590/1516-4446-2020-1488

Graham, E. L., Clark, J. R., Orban, Z. S., Lim, P. H., Szymanski, A. L., Taylor, C., DiBiase, R. M., Jia, D. T., Balabanov, R., Ho, S. U., Batra, A., Liotta, E. M., & Koralnik, I. J. (2021). Persistent neurologic symptoms and cognitive dysfunction in non-hospitalized Covid-19 "long haulers". Annals of clinical and translational neurology, 8(5), 1073–1085. https://doi.org/10.1002/acn3.51350

Guilmot, A., Maldonado Slootjes, S., Sellimi, A., Bronchain, M., Hanseeuw, B., Belkhir, L., Yombi, J. C., De Greef, J., Pothen, L., Yildiz, H., Duprez, T., Fillée, C., Anantharajah, A., Capes, A., Hantson, P., Jacquerye, P., Raymackers, J. M., London, F., El Sankari, S., Ivanoiu, A., & van Pesch, V. (2021). Immune-mediated neurological syndromes in SARS-CoV-2-infected patients. Journal of neurology, 268(3), 751–757. https://doi.org/10.1007/s00415-020-10108-x

Jacobs, L. M., Gazagnes, M. D., Sanoussi, S., Collart, F., & Mesquita, M. D. C. F. (2021). Cognitive impairment in a patient with COVID-19 on hemodialysis: Too dangerous to neglect!. Hemodialysis international. International Symposium on Home Hemodialysis, 25(4), E44–E47. https://doi.org/10.1111/hdi.12955

Jha, N. K., Ojha, S., Jha, S. K., Dureja, H., Singh, S. K., Shukla, S. D., Chellappan, D. K., Gupta, G., Bhardwaj, S., Kumar, N., Jeyaraman, M., Jain, R., Muthu, S., Kar, R., Kumar, D., Goswami, V. K., Ruokolainen, J., Kesari, K. K., Singh, S. K., & Dua, K. (2021). Evidence of Coronavirus (CoV) Pathogenesis and Emerging Pathogen SARS-CoV-2 in the Nervous System: A Review on Neurological Impairments and Manifestations. Journal of molecular neuroscience : MN, 71(11), 2192–2209. https://doi.org/10.1007/s12031-020-01767-6

Koralnik, I. J., & Tyler, K. L. (2020). COVID-19: A Global Threat to the Nervous System. Annals of neurology, 88(1), 1–11. https://doi.org/10.1002/ana.25807

Levin, S. N., Venkatesh, S., Nelson, K. E., Li, Y., Aguerre, I., Zhu, W., Masown, K., Rimmer, K. T., Diaconu, C. I., Onomichi, K. B., Leavitt, V. M., Levine, L. L., Strauss-Farber, R., Vargas, W. S., Banwell, B., Bar-Or, A., Berger, J. R., Goodman, A. D., Longbrake, E. E., Oh, J., & Multiple Sclerosis Resilience to COVID-19 (MSReCOV) Collaborative (2021). Manifestations and impact of the COVID-19 pandemic in neuroinflammatory diseases. Annals of clinical and translational neurology, 8(4), 918–928. https://doi.org/10.1002/acn3.51314

Mendes, K. D. S. (2008). Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto & contexto-enfermagem. 17(11):758-764. 10.1590/S0104-07072008000400018

Mirfazeli, F. S., Sarabi-Jamab, A., Jahanbakhshi, A., Kordi, A., Javadnia, P., Shariat, S. V., Aloosh, O., Almasi-Dooghaee, M., & Faiz, S. H. R. (2020). Neuropsychiatric manifestations of COVID-19 can be clustered in three distinct symptom categories. Scientific reports, 10(1), 20957. https://doi.org/10.1038/s41598-020-78050-6

Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., Shamseer, L., Tetzlaff, J. M., Akl, E. A., Brennan, S. E., Chou, R., Glanville, J., Grimshaw, J. M., Hróbjartsson, A., Lalu, M. M., Li, T., Loder, E. W., Mayo-Wilson, E., McDonald, S., McGuinness, L. A., & Moher, D. (2021). The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed.), 372, n71. https://doi.org/10.1136/bmj.n71

Rass, V., Beer, R., Schiefecker, A. J., Kofler, M., Lindner, A., Mahlknecht, P., Heim, B., Limmert, V., Sahanic, S., Pizzini, A., Sonnweber, T., Tancevski, I., Scherfler, C., Zamarian, L., Bellmann-Weiler, R., Weiss, G., Djamshidian, A., Kiechl, S., Seppi, K., Loeffler-Ragg, J., & Helbok, R. (2021). Neurological outcome and quality of life 3 months after COVID-19: A prospective observational cohort study. European journal of neurology, 28(10), 3348–3359. https://doi.org/10.1111/ene.14803

Rifino, N., Censori, B., Agazzi, E., Alimonti, D., Bonito, V., Camera, G., Conti, M. Z., Foresti, C., Frigeni, B., Gerevini, S., Grimoldi, M., La Gioia, S., Partziguian, T., Quadri, S., Riva, R., Servalli, M. C., Sgarzi, M., Storti, B., Vedovello, M., Venturelli, E., & Sessa, M. (2021). Neurologic manifestations in 1760 COVID-19 patients admitted to Papa Giovanni XXIII Hospital, Bergamo, Italy. Journal of neurology, 268(7), 2331–2338. https://doi.org/10.1007/s00415-020-10251-5

Romero-Sánchez, C. M., Díaz-Maroto, I., Fernández-Díaz, E., Sánchez-Larsen, Á., Layos-Romero, A., García-García, J., González, E., Redondo-Peñas, I., Perona-Moratalla, A. B., Del Valle-Pérez, J. A., Gracia-Gil, J., Rojas-Bartolomé, L., Feria-Vilar, I., Monteagudo, M., Palao, M., Palazón-García, E., Alcahut-Rodríguez, C., Sopelana-Garay, D., Moreno, Y., Ahmad, J., & Segura, T. (2020). Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry. Neurology, 95(8), e1060–e1070. https://doi.org/10.1212/WNL.0000000000009937

Roy, D., Ghosh, R., Dubey, S., Dubey, M. J., Benito-León, J., & Kanti Ray, B. (2021). Neurological and Neuropsychiatric Impacts of COVID-19 Pandemic. The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques, 48(1), 9–24. https://doi.org/10.1017/cjn.2020.173

Serrano-Castro, P. J., Garzón-Maldonado, F. J., Casado-Naranjo, I., Ollero-Ortiz, A., Mínguez-Castellanos, A., Iglesias-Espinosa, M., Baena-Palomino, P., Sánchez-Sanchez, V., Sánchez-Pérez, R. M., Rubi-Callejon, J., Estévez-María, J. C., Galeano-Bilbao, B., Romero-Imbroda, J., Sobrino, B., Arrabal-Gomez, C., Oliver-Martos, B., Muñoz-Becerra, L., Requena, N., González Álvarez de Sotomayor, M. D. M., Estivill-Torrus, G., & de Fonseca, F. R. (2022). The cognitive and psychiatric subacute impairment in severe Covid-19. Scientific reports, 12(1), 3563. https://doi.org/10.1038/s41598-022-07559-9.

Sinanović, O., Muftić, M., & Sinanović, S. (2020). COVID-19 Pandemia: Neuropsychiatric Comorbidity and Consequences. Psychiatria Danubina, 32(2), 236–244. https://doi.org/10.24869/psyd.2020.236

Tomasino, B., Pellitteri, G., Bax, F., Marini, A., Surcinelli, A., Gigli, G. L., & Valente, M. (2022). Multisensory mental representation in covid-19 patients and the possibility of long-lasting gustatory and olfactory dysfunction in the CNS. Scientific reports, 12(1), 7340. https://doi.org/10.1038/s41598-022-11119-6

Wiersinga, W. J., Rhodes, A., Cheng, A. C., Peacock, S. J., & Prescott, H. C. (2020). Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19): A Review. JAMA, 324(8), 782–793. https://doi.org/10.1001/jama.2020.12839

Yuksel, H., Gursoy, G. T., Dirik, E. B., Kenar, S. G., Bektas, H., Yamanel, L., & Guner, H. R. (2021). Neurological manifestations of COVID-19 in confirmed and probable cases: A descriptive study from a large tertiary care center. Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 86, 97–102. https://doi.org/10.1016/j.jocn.2021.01.002

Zhou, Y., Xu, J., Hou, Y., Leverenz, J. B., Kallianpur, A., Mehra, R., Liu, Y., Yu, H., Pieper, A. A., Jehi, L., & Cheng, F. (2021). Network medicine links SARS-CoV-2/COVID-19 infection to brain microvascular injury and neuroinflammation in dementia-like cognitive impairment. bioRxiv : the preprint server for biology, 2021.03.15.435423. https://doi.org/10.1101/2021.03.15.435423

Ziemele, D., Ķauķe, G., Skrējāne, K., Jaunozoliņa, L., & Karelis, G. (2021). A fatal case of COVID-19-associated acute necrotizing encephalopathy. European journal of neurology, 28(11), 3870–3872. https://doi.org/10.1111/ene.14966

Published

27/12/2023

How to Cite

TEIXEIRA, L. V.; SILVA, V. C. da .; RIBEIRO, K. B. Main neurological and psychiatric manifestations in the context of the COVID-19 pandemic. Research, Society and Development, [S. l.], v. 12, n. 14, p. e110121444563, 2023. DOI: 10.33448/rsd-v12i14.44563. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/44563. Acesso em: 17 nov. 2024.

Issue

Section

Health Sciences