Neuropsychiatric manifestations of COVID-19 and possible pathogenic mechanisms: Insights from other coronaviruses
Neuropsychiatric manifestations of COVID-19 and possible pathogenic mechanisms: Insights from other coronaviruses
复制标题
DOI：
10.1016/j.ajp.2020.102350
复制
发表时间：
2020-12-01
影响因子：
9.5
通讯作者：
Viswanath, Biju
中科院分区：
文献类型：
--
作者：
Banerjee, Debanjan;Viswanath, Biju
由SARS-CoV-2引起的2019冠状病毒病（COVID-19）大流行已成为全球公共卫生威胁。尽管与COVID-19相关的恐惧、焦虑和压力已被深入研究，但SARS-CoV-2对中枢神经系统（CNS）的直接影响仍然难以捉摸。与早期冠状病毒（CoV）爆发（如严重急性呼吸系统综合征，SARS和中东呼吸综合征，MERS）相关的研究表明，CoV具有嗜神经性，并可能导致过多的神经精神影响。尽管目前管理COVID-19的卫生优先事项仍限于遏制和针对肺部症状，但感染的潜在急性和长期神经精神后遗症可能会增加发病率并恶化生活质量。新出现的证据显示新型冠状病毒的神经传播。谵妄、脑病、嗅觉障碍、急性行为改变、头痛和脑血管意外是其常见的神经精神并发症。这些与外周免疫标记物的增加、感染的严重程度和病死率直接相关。本叙述性综述综合了与COVID-19神经精神表现相关的现有证据。此外，由于SARS-CoV-2与其早期同源物在结构和功能上具有相似性，本文根据对其他冠状病毒爆发的研究，提出了可能的长期神经心理后遗症和致病机制。
Coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has emerged as a global public health threat. Though the fear, anxiety, and stress related to COVID-19 have been studied in depth, the direct effects of SARS-CoV-2 on the central nervous system (CNS) remain elusive. Research related to the earlier coronavirus (CoV) outbreaks (like Severe Acute Respiratory Syndrome, SARS and Middle East Respiratory Syndrome, MERS) shows the neurotropic nature of CoV and the plethora of neuropsychiatric effects that it can cause. Though the current health priorities in managing COVID-19 remain restricted to containment and targeting pulmonary symptoms, the potential acute and long-term neuropsychiatric sequelae of the infection can increase morbidity and worsen the quality of life. Emerging evidence shows neural spread of the novel coronavirus. Delirium, encephalopathy, olfactory disturbances, acute behavioral changes, headache and cerebrovascular accidents are its common neuropsychiatric complications. These are directly related to increase in peripheral immunological markers, severity of infection and case fatality rate. This narrative review synthesizes available evidence related to the neuropsychiatric manifestations of COVID-19. Also, as SARS-CoV-2 shares structural and functional similarities with its earlier congeners, this article proposes possible long-term neuropsychological sequelae and pathogenic mechanisms for the same, based on research in the other coronavirus outbreaks.