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新冠病毒病炎症背景下的抑郁和神经认知障碍

Depressive and Neurocognitive Disorders in the Context of the Inflammatory Background of COVID-19.

作者信息

Dąbrowska Eliza, Galińska-Skok Beata, Waszkiewicz Napoleon

机构信息

Department of Psychiatry, Medical University of Bialystok, pl. Brodowicza 1, 16-070 Choroszcz, Poland.

出版信息

Life (Basel). 2021 Oct 8;11(10):1056. doi: 10.3390/life11101056.

Abstract

The dysfunctional effects of the coronavirus disease 2019 (COVID-19) infection on the nervous system are established. The manifestation of neuropsychiatric symptoms during and after infection is influenced by the neuroinvasive and neurotrophic properties of SARS-CoV-2 as well as strong inflammation characterised by a specific "cytokine storm". Research suggests that a strong immune response to a SARS-CoV-2 infection and psychological stressors related to the pandemic may cause chronic inflammatory processes in the body with elevated levels of inflammatory markers contributing to the intensification of neurodegenerative processes. It is suggested that neuroinflammation and associated central nervous system changes may significantly contribute to the etiopathogenesis of depressive disorders. In addition, symptoms after a COVID-19 infection may persist for up to several weeks after an acute infection as a post-COVID-19 syndrome. Moreover, previous knowledge indicates that among SSRI (selective serotonin reuptake inhibitor) group antidepressants, fluoxetine is a promising drug against COVID-19. In conclusion, further research, observation and broadening of the knowledge of the pathomechanism of a SARS-CoV-2 infection and the impact on potential complications are necessary. It is essential to continue research in order to assess the long-term neuropsychiatric effects in COVID-19 patients and to find new therapeutic strategies.

摘要

2019冠状病毒病(COVID-19)感染对神经系统的功能障碍作用已得到证实。感染期间及之后神经精神症状的表现受严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的神经侵袭和神经营养特性以及以特定“细胞因子风暴”为特征的强烈炎症影响。研究表明,对SARS-CoV-2感染的强烈免疫反应以及与大流行相关的心理应激源可能导致体内慢性炎症过程,炎症标志物水平升高会加剧神经退行性过程。有人提出,神经炎症及相关的中枢神经系统变化可能在抑郁症的病因发病机制中起重要作用。此外,COVID-19感染后的症状可能在急性感染后持续数周,成为一种新冠后综合征。而且,既往知识表明,在选择性5-羟色胺再摄取抑制剂(SSRI)类抗抑郁药中,氟西汀是一种有前景的抗COVID-19药物。总之,有必要进一步开展研究、进行观察并拓宽对SARS-CoV-2感染发病机制及其对潜在并发症影响的认识。继续开展研究以评估COVID-19患者的长期神经精神影响并寻找新的治疗策略至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1415/8541562/14cecc5327bc/life-11-01056-g001.jpg

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