Review
The neuropsychiatric manifestations of COVID-19: Interactions with psychiatric illness and pharmacological treatment

https://doi.org/10.1016/j.biopha.2020.111200Get rights and content
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open access

Highlights

  • Inflammation is implicated in SARS-CoV-2 infection and psychiatric disorders.

  • SARS-CoV-2 is a risk for development of a psychiatric disorder.

  • Anti-inflammatory effects of psychotropics may adversely affect COVID-19 outcome.

  • Select adjunctive treatments may benefit COVID-19 psychiatric complications.

Abstract

The recent outbreak of the corona virus disease (COVID-19) has had major global impact. The relationship between severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection and psychiatric diseases is of great concern, with an evident link between corona virus infections and various central and peripheral nervous system manifestations. Unmitigated neuro-inflammation has been noted to underlie not only the severe respiratory complications of the disease but is also present in a range of neuro-psychiatric illnesses. Several neurological and psychiatric disorders are characterized by immune-inflammatory states, while treatments for these disorders have distinct anti-inflammatory properties and effects. With inflammation being a common contributing factor in SARS-CoV-2, as well as psychiatric disorders, treatment of either condition may affect disease progression of the other or alter response to pharmacological treatment. In this review, we elucidate how viral infections could affect pre-existing psychiatric conditions and how pharmacological treatments of these conditions may affect overall progress and outcome in the treatment of SARS-CoV-2. We address whether any treatment-induced benefits and potential adverse effects may ultimately affect the overall treatment approach, considering the underlying dysregulated neuro-inflammatory processes and potential drug interactions. Finally, we suggest adjunctive treatment options for SARS-CoV-2-associated neuro-psychiatric symptoms.

Keywords

SARS-CoV-2
COVID-19
Psychiatric diseases
Inflammation
Pharmacological treatment

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These authors contributed equally to this work.