In wake of COVID-19 pandemic, a crashing wave of brain and mental health problems?

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In a new paper, researchers suggest that in the aftermath of the novel coronavirus pandemic, a host of neuropsychiatric challenges may remain—or emerge—for those recovering from COVID-19 infections.

They warn that 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 a recovered patient.

The research was conducted by a team at the University of California San Diego School of Medicine.

Encephalopathy is a broad term for any insult that alters brain function or structure, and therefore one’s mental status.

Demyelination is the loss of the protective myelin sheathing of nerve cells, resulting in neurological problems.

The team says COVID-19 is a significant psychological stressor, both for individuals and communities.

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 has been focused on the impact the virus itself may have on the human central nervous system (CNS) and related neuropsychiatric outcomes.

The authors noted that studies of past respiratory viral pandemics indicate diverse types of neuropsychiatric symptoms can arise, including increased incidence of insomnia, anxiety, depression, mania, suicidality, and delirium, which followed influenza pandemics in the 18th and 19th centuries.

During more recent viral outbreaks, such as SARS-CoV-1 in 2003, H1N1 in 2009, and MERS-CoV in 2012, there were subsequent reports of higher rates of narcolepsy, seizures, encephalitis (brain inflammation), Guillain-Barre syndrome and other neuromuscular and demyelinating conditions.

Reports are already surfacing of acute CNS-associated symptoms in individuals affected by COVID-19, including greater stroke incidence in severely infected patients in Wuhan, China, along with delirium and loss of smell and taste senses.

The researchers 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.

One author of the study is Suzi Hong, Ph.D., an associate professor in the departments of Psychiatry and Family Medicine and Public Health at UC San Diego School of Medicine.

The study is published in the journal Brain, Behavior, and Immunity.

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