University Magna Graecia, Catanzaro, Italy.
Sapienza University Rome, Rome, Italy.
Transl Psychiatry. 2020 Jul 30;10(1):261. doi: 10.1038/s41398-020-00949-5.
The Coronavirus Disease 2019 (COVID-19) represents a severe multiorgan pathology which, besides cardio-respiratory manifestations, affects the function of the central nervous system (CNS). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), similarly to other coronaviruses demonstrate neurotropism; the viral infection of the brain stem may complicate the course of the disease through damaging central cardio-respiratory control. The systemic inflammation as well as neuroinflammatory changes are associated with massive increase of the brain pro-inflammatory molecules, neuroglial reactivity, altered neurochemical landscape and pathological remodelling of neuronal networks. These organic changes, emerging in concert with environmental stress caused by experiences of intensive therapy wards, pandemic fears and social restrictions, promote neuropsychiatric pathologies including major depressive disorder, bipolar disorder (BD), various psychoses, obsessive-compulsive disorder and post-traumatic stress disorder. The neuropsychiatric sequelae of COVID-19 represent serious clinical challenge that has to be considered for future complex therapies.
新型冠状病毒病 2019(COVID-19)代表一种严重的多器官疾病,除了心肺表现外,还影响中枢神经系统(CNS)的功能。与其他冠状病毒一样,严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)具有嗜神经性;病毒感染脑干可能通过损害中枢心肺控制使疾病复杂化。全身炎症以及神经炎症变化与大脑促炎分子、神经胶质反应、神经化学环境改变和神经元网络病理性重塑的大量增加有关。这些有机变化与密集治疗病房、大流行恐惧和社会限制所造成的环境压力一起出现,促进了神经精神病理学,包括重度抑郁症、双相情感障碍(BD)、各种精神病、强迫症和创伤后应激障碍。COVID-19 的神经精神后遗症是一个严重的临床挑战,需要考虑未来的复杂治疗。