COVID-19: Which neuropsychiatric consequences threaten?

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In principle, “viral infections of the respiratory tract can have multisystemic effects, including on the central nervous system (CNS), and thus trigger a spectrum of psychiatric and neurological disorders,” emphasize the authors of the paper. It is now also known that COVID-19 can cause various CNS abnormalities with potentially serious and long-term consequences.

The possible acute and chronic neuropsychiatric consequences of COVID-19 are discussed in a current article in the renowned journal “BMJ”. At first it becomes clear that there are still massive uncertainties in this area. In addition, first study results are named, which indicate acute damage to the central nervous system (CNS) and long-term complaints such as chronic fatigue or cognitive impairment as a result of COVID-19.

Up to now, medicine has focused on the acute physical effects and their alleviation in COVID-19, but there are also psychological and neurological consequences to be feared, which can considerably impair affected persons in the long term.

Consequences of COVID-19
Psychological and neurological effects of COVID-19

Various studies have also shown evidence of encephalitis, leukoencephalopathy and brain microbleeding in severe COVID-19 courses, writes Matthew Butler’s team from the Institute of Psychiatry, Psychology and Neuroscience, at King’s College London.

Damage to the central nervous system

In addition, there are other biological mechanisms, including autoimmunity, which may be as relevant for subsequent psychological symptoms as the psychological trauma of the life-threatening disease and pandemic-related socioeconomic stress, the experts added.

According to the researchers, acute confusion (delirium) is the first possible neuropsychiatric symptom. This could also be the only characteristic of the disease in older adults and dementia patients. Screening for delirium is therefore recommended, especially for older people or those with pre-existing dementia. One third of patients with delirium reported cognitive and behavioral abnormalities even after discharge.

Depression and anxiety are mentioned as further possible complaints in the acute phase of the infection. In addition, the UK-based CoroNerve Group has collected data on neurological and neuropsychiatric disorders associated with COVID-19, showing that psychosis, mood disorders and a so-called catatonia, as well as encephalopathies, encephalitis and other neurological disorders can also occur, the researchers report.

The risk of anxiety, depression and post-traumatic stress disorder (PTSD) is also relatively high in people who have been hospitalized for COVID-19. In addition, disabling fatigue and cognitive difficulties often occur after discharge, according to the authors of the article. Even patients who did not need hospital treatment reported a variety of symptoms that can occur months after an acute infection.

Further research, which will feed into clinical guidelines and enhance our understanding of the underlying mechanisms of COVID-19, is urgently needed, the researchers added. However, a complete picture may take years to emerge. (fp)

Although it is still too early to estimate the full effect of the long-term complications, the experts conclude that the long-term consequences of COVID-19 “will lead to significant morbidity in the population with serious consequences for health and social care.

WashingtonNewsday Health and Wellness.

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