Mental impact of COVID-19 could be long-lasting, UCSD researchers say

Coronavirus
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SAN DIEGO — People recovering from COVID-19 infections could experience a host of mental disorders and related challenges even after the pandemic subsides, according to three researchers at the UC San Diego School of Medicine.

“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,” the authors warn in a new report, posted online Monday in the journal Brain, Behavior, and Immunity.

“Our article seeks to bring the medical community’s attention to the need for monitoring and investigations to mitigate such outcomes, not to cause panic among individuals whose lives are already greatly affected by this pandemic.”

Encephalopathy is a broad term for anything that alters brain function or structure, and therefore one’s mental status. Demyelination is loss of the protective myelin sheathing of nerve cells, resulting in neurological problems.

“COVID-19 is a significant psychological stressor, both for individuals and communities,” said senior author Dr. Suzi Hong, associate professor of psychiatry and family medicine and public health at UCSD School of Medicine. “There are fears of illness, death and uncertainty of the future. This pandemic is a potential source of direct and vicarious traumatization for everyone.”

But less attention, wrote Hong and co-authors Dr. Emily Troyer and Dr. Jordan Kohn, has been focused on the impact the virus itself may have on the human central nervous system and related psychiatric outcomes. The authors noted that studies of past respiratory viral pandemics indicate many neuropsychiatric symptoms can arise, including increased incidence of insomnia, anxiety, depression, mania, suicidal thoughts, and delirium, which followed influenza pandemics in the 18th and 19th centuries.

During more recent viral outbreaks — such as SARS in 2003, H1N1 in 2009 and MERS in 2012 — there were subsequent reports of higher rates of narcolepsy, seizures, brain inflammation and other neuromuscular and brain- altering conditions.

Hong said patients in Wuhan, China with severe coronavirus infections were exhibiting greater stroke incidence along with delirium and loss of smell and taste senses.

Hong, Troyer and Kohn say the neuropsychiatric consequences of the current novel coronavirus pandemic are not yet known, but likely will be significant and last for years. They said emerging evidence suggests the biomedical community should begin monitoring for symptoms of neuropsychiatric conditions and the neuroimmune status of persons exposed to SARS-CoV-2, the virus that causes COVID-19.

“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, and how to better prepare for pandemics to come,” Hong said.

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