Neurocognitive Manifestations of SARSCoV2: A Narrative Review of Mechanisms
International Clinical Neuroscience Journal,
Vol. 8 No. 1 (2021),
30 December 2020
,
Page 3-9
Abstract
Since the outbreak of COVID-19 that is caused by severe acute respiratory syndrome coronavirus 2
(SARS-CoV-2) in 2020 throughout the world, a lot of aspects of people’s lives are affected including
their psychological status. Follow-up assessment of survivors of this infection showed that they
had multiple psychological disorders including depression, panic attacks, obsessive compulsive
disorder, and post-traumatic stress disorder. It is estimated that more than one-third of patients with
COVID-19 experience neuropsychiatric symptoms, including headache, paresthesia, and disturbed
consciousness. Among patients affected by COVID-19, there are different mechanisms that can
cause cognitive dysfunction. COVID-19 can affect the central nervous system (CNS) directly by
invasion and indirectly by inducing hypoxia, inflammation, and delirium. The pandemic and fear
of infection can also cause anxiety which impairs the cognition as well. By assessing the patients’
cognition and knowing the higher probable cause of cognitive impairment, we can form a better
strategy to better treat the impairment. Cognitive behavioral therapy can be effective in reducing the
anxiety and cognitive rehabilitation therapy (CRT) can be used to lower the detrimental effects of
cognitive impairment caused by COVID-19.
- COVID-19
- Cognitive dysfunction
- Anxiety
- Depression
- Delirium
- Inflammation
- Hypoxia
How to Cite
References
Troyer EA, Kohn JN, Hong S. Are we facing a crashing wave of neuropsychiatric sequelae of COVID-19? Neuropsychiatric symptoms and potential immunologic mechanisms. Brain, behavior, and immunity. 2020.
Zoghi A, Ramezani M, Roozbeh M, Darazam IA, Sahraian MA. A case of possible atypical demyelinating event of the central nervous system following COVID-19. Multiple Sclerosis and Related Disorders. 2020;44:102324.
Nepal G, Rehrig JH, Shrestha GS, Shing YK, Yadav JK, Ojha R, et al. Neurological manifestations of COVID-19: a systematic review. Critical Care. 2020;24(1):421.
Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, et al. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain, behavior, and immunity. 2020.
Okusaga O, Yolken RH, Langenberg P, Lapidus M, Arling TA, Dickerson FB, et al. Association of seropositivity for influenza and coronaviruses with history of mood disorders and suicide attempts. Journal of affective disorders. 2011;130(1-2):220-5.
Mao L, Jin H, Wang M, Hu Y, Chen S, He Q. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol. 2020 Apr. 2020.
Rogers JP, Chesney E, Oliver D, Pollak TA, McGuire P, Fusar-Poli P, et al. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. The Lancet Psychiatry. 2020.
Desforges M, Le Coupanec A, Dubeau P, Bourgouin A, Lajoie L, Dubé M, et al. Human coronaviruses and other respiratory viruses: underestimated opportunistic pathogens of the central nervous system? Viruses. 2020;12(1):14.
Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. Rapid review. Lancet. 2020;395:912-20.
Hayhurst CJ, Pandharipande PP, Hughes CG. Intensive Care Unit Delirium: A Review of Diagnosis, Prevention, and Treatment. Anesthesiology. 2016;125(6):1229-41.
Beach SR, Praschan NC, Hogan C, Dotson S, Merideth F, Kontos N, et al. Delirium in COVID-19: A case series and exploration of potential mechanisms for central nervous system involvement. General Hospital Psychiatry. 2020.
Helms J, Kremer S, Merdji H, Clere-Jehl R, Schenck M, Kummerlen C, et al. Neurologic features in severe SARS-CoV-2 infection. New England Journal of Medicine. 2020.
Mcloughlin BC, Miles A, Webb TE, Knopp P, Eyres C, Fabbri A, et al. Functional and cognitive outcomes after COVID-19 delirium. medRxiv. 2020.
Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS‐CoV2 may play a role in the respiratory failure of COVID‐19 patients. Journal of medical virology. 2020;92(6):552-5.
Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. European Archives of Oto-Rhino-Laryngology. 2020:1-11.
Royall DR, Chiodo LK, Polk MJ, Jaramillo CJ. Severe dysosmia is specifically associated with Alzheimer-like memory deficits in nondemented elderly retirees. Neuroepidemiology. 2002;21(2):68-73.
Bombini MF, Peres FA, Lapa AT, Sinicato NA, Quental BR, Pincelli ÁdSM, et al. Olfactory function in systemic lupus erythematosus and systemic sclerosis. A longitudinal study and review of the literature. Autoimmunity reviews. 2018;17(4):405-12.
Cipriani G, Danti S, Nuti A, Carlesi C, Lucetti C, Di Fiorino M. A complication of coronavirus disease 2019: delirium. Acta Neurologica Belgica. 2020:1-6.
Filatov A, Sharma P, Hindi F, Espinosa PS. Neurological complications of coronavirus disease (COVID-19): encephalopathy. Cureus. 2020;12(3).
Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: retrospective study. Bmj. 2020;368.
Zucco GM, Ingegneri G. Olfactory deficits in HIV-infected patients with and without AIDS dementia complex. Physiology & behavior. 2004;80(5):669-74.
Mueller C, Temmel A, Quint C, Rieger A, Hummel T. Olfactory function in HIV-positive subjects. Acta oto-laryngologica. 2002;122(1):67-71.
Ren SY, Gao RD, Chen YL. Fear can be more harmful than the severe acute respiratory syndrome coronavirus 2 in controlling the corona virus disease 2019 epidemic. World J Clin Cases. 2020;8(4):652-7.
Dutra SJ, Marx BP, McGlinchey R, DeGutis J, Esterman M. Reward Ameliorates Posttraumatic Stress Disorder-Related Impairment in Sustained Attention. Chronic Stress. 2018;2:2470547018812400.
Liu CH, Doan SN. Psychosocial Stress Contagion in Children and Families During the COVID-19 Pandemic. Clinical Pediatrics. 2020;59(9-10):853-5.
Asmundson GJ, Paluszek MM, Landry CA, Rachor GS, McKay D, Taylor S. Do pre-existing anxiety-related and mood disorders differentially impact COVID-19 stress responses and coping? Journal of anxiety disorders. 2020;74:102271.
Fullana MA, Hidalgo-Mazzei D, Vieta E, Radua J. Coping behaviors associated with decreased anxiety and depressive symptoms during the COVID-19 pandemic and lockdown. Journal of Affective Disorders. 2020;275:80-1.
Speth MM, Singer‐Cornelius T, Oberle M, Gengler I, Brockmeier SJ, Sedaghat AR. Mood, anxiety and olfactory dysfunction in COVID‐19: evidence of central nervous system involvement? The Laryngoscope. 2020;130(11):2520-5.
Ntaios G, Michel P, Georgiopoulos G, Guo Y, Li W, Xiong J, et al. Characteristics and outcomes in patients with COVID-19 and acute ischemic stroke: the global COVID-19 stroke registry. Stroke. 2020;51(9):e254-e8.
Tatemichi T, Desmond D, Stern Y, Paik M, Sano M, Bagiella E. Cognitive impairment after stroke: frequency, patterns, and relationship to functional abilities. Journal of Neurology, Neurosurgery & Psychiatry. 1994;57(2):202-7.
Patel MD, Coshall C, Rudd AG, Wolfe CD. Cognitive impairment after stroke: clinical determinants and its associations with long‐term stroke outcomes. Journal of the American Geriatrics Society. 2002;50(4):700-6.
Sachdev PS, Brodaty H, Valenzuela M, Lorentz L, Looi J, Wen W, et al. The neuropsychological profile of vascular cognitive impairment in stroke and TIA patients. Neurology. 2004;62(6):912-9.
Mahon S, Parmar P, Barker-Collo S, Krishnamurthi R, Jones K, Theadom A, et al. Determinants, prevalence, and trajectory of long-term post-stroke cognitive impairment: results from a 4-year follow-up of the ARCOS-IV study. Neuroepidemiology. 2017;49(3-4):129-34.
Yaffe K, Laffan AM, Harrison SL, Redline S, Spira AP, Ensrud KE, et al. Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. Jama. 2011;306(6):613-9.
Thachil J. Hypoxia—An overlooked trigger for thrombosis in COVID‐19 and other critically ill patients. Journal of Thrombosis and Haemostasis. 2020;18(11):3109-10.
Arachchillage DJ, Stacey A, Akor F, Scotz M, Laffan M. Thrombolysis restores perfusion in COVID‐19 hypoxia. British journal of haematology. 2020;190(5):e270-e4.
Yadav H, Kor DJ. Platelets in the pathogenesis of acute respiratory distress syndrome. American Journal of Physiology-Lung Cellular and Molecular Physiology. 2015;309(9):L915-L23.
Mao L, Wang M, Chen S, He Q, Chang J, Hong C, et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. 2020.
Ardila A, Lahiri D. Executive dysfunction in COVID-19 patients. Diabetes Metab Syndr. 2020;14(5):1377-8.
Batty G, Deary I, Luciano M, Altschul D, Kivimäki M, Gale C. Psychosocial factors and hospitalisations for COVID-19: Prospective cohort study based on a community sample. Brain, Behavior, and Immunity. 2020;89:569-78.
Alonso-Lana S, Marquié M, Ruiz A, Boada M. Cognitive and neuropsychiatric manifestations of COVID-19 and effects on elderly individuals with dementia. Frontiers in aging neuroscience. 2020;12.
Egbert AR, Cankurtaran S, Karpiak S. Brain abnormalities in COVID-19 acute/subacute phase: A rapid systematic review. Brain, behavior, and immunity. 2020.
Alonso-Lana S, Marquié M, Ruiz A, Boada M. Cognitive and Neuropsychiatric Manifestations of COVID-19 and Effects on Elderly Individuals With Dementia. Front Aging Neurosci. 2020;12:588872.
Romero-Sánchez CM, Díaz-Maroto I, Fernández-Díaz E, Sánchez-Larsen Á, Layos-Romero A, García-García J, et al. Neurologic manifestations in hospitalized patients with COVID-19. The ALBACOVID registry. 2020;95(8):e1060-e70.
Bianchetti A, Rozzini R, Guerini F, Boffelli S, Ranieri P, Minelli G, et al. Clinical Presentation of COVID19 in Dementia Patients. The Journal of Nutrition, Health & Aging. 2020:1.
Parra A, Juanes A, Losada C, Álvarez-Sesmero S, Santana V, Martí I, et al. Psychotic symptoms in COVID-19 patients. A retrospective descriptive study. Psychiatry research. 2020;291:113254.
Chaumont H, San-Galli A, Martino F, Couratier C, Joguet G, Carles M, et al. Mixed central and peripheral nervous system disorders in severe SARS-CoV-2 infection. Journal of Neurology. 2020:1-7.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet. 2020;395(10223):497-506.
Chen G, Wu D, Guo W, Cao Y, Huang D, Wang H, et al. Clinical and immunological features of severe and moderate coronavirus disease 2019. The Journal of clinical investigation. 2020;130(5).
Akiyama H, Barger S, Barnum S, Bradt B, Bauer J, Cole GM, et al. Inflammation and Alzheimer’s disease. Neurobiology of aging. 2000;21(3):383-421.
Sy M, Kitazawa M, Medeiros R, Whitman L, Cheng D, Lane TE, et al. Inflammation induced by infection potentiates tau pathological features in transgenic mice. The American journal of pathology. 2011;178(6):2811-22.
Jacomy H, Fragoso G, Almazan G, Mushynski WE, Talbot PJ. Human coronavirus OC43 infection induces chronic encephalitis leading to disabilities in BALB/C mice. Virology. 2006;349(2):335-46.
Gordon DE, Jang GM, Bouhaddou M, Xu J, Obernier K, White KM, et al. A SARS-CoV-2 protein interaction map reveals targets for drug repurposing. Nature. 2020:1-13.
Sale P, Gentile G. Cognitive Rehabilitation Therapy for Neurologic Diseases. Rehabilitation Medicine for Elderly Patients: Springer; 2018. p. 341-7.
Shoulson I, Wilhelm EE, Koehler R. Cognitive rehabilitation therapy for traumatic brain injury: evaluating the evidence: National Academies Press; 2012.
Bozoki A, Radovanovic M, Winn B, Heeter C, Anthony JC. Effects of a computer-based cognitive exercise program on age-related cognitive decline. Archives of Gerontology and Geriatrics. 2013;57(1):1-7.
Antoni MH, Lehman JM, Kilbourn KM, Boyers AE, Culver JL, Alferi SM, et al. Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology. 2001;20(1):20.
- Abstract Viewed: 401 times
- PDF Downloaded: 580 times