Psychiatric Manifestations of COVID-19: A Literature Review

COVID-19 (coronavirus disease of 2019) occurs due to the highly contagious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It uses angiotensin-converting enzyme- 2 (ACE-2) as its primary receptor to enter the host cell. Recent reports suggest that this pathogen also has a large impact on the CNS alongside other organs. Various inflammatory mediators, such as cytokines, chemokines, and numerous metabolites, are poorly regulated during infection as well as in several psychiatric diseases, which leads to conditions of hypoxia and cytokine storm. The persistence of COVID-19 infection may also result in aggravation of the already present neuro-psychiatric symptoms in patients.

We systematically searched various sources of journals and assessed the varied neurological routes of propagation and pathogenesis of SARS-CoV-2 neurotoxicity, like ACE2-mediated neuroinvasion induced hypoxia and the cytokine storm syndrome. Several case studies were also referred to obtain a better idea of the current mental health scenario as a consequence of infection and inflammation due to SARS-CoV-2.

Several risk factors for the causation of mental health issues during as well as after the infection include female gender, presence of necrosis, and pain in avascular regions. Most psychiatric disorders are directly associated with the socioeconomic and psychosocial changes that have occurred as a consequence of the pandemic. These psychiatric manifestations have only started to unravel, which calls for the development of faster means of diagnosis and integrated pharmacological and epidemiological studies to curb the growing rate of neuronal complications as well as mortality.