Pallanti Stefano, Di Ponzio Michele
Department of Psychiatry and Health Sciences, Institute of Neurosciences, 50121 Florence, Italy.
Department of Psychiatry and Behavioural Sciences, Albert Einstein College of Medicine, New York, NY 10461, USA.
Children (Basel). 2023 Mar 30;10(4):648. doi: 10.3390/children10040648.
COVID-19 impacted the entire world's population, frequently resulting in long-lasting neuropsychiatric complications. Furthermore, social distancing, lockdowns and fear for one's personal health worsen individual psychological wellbeing, especially in children and adolescents. Herein, we discuss the results of studies that specifically reported data about the impact of the COVID-19 pandemic or infection on children with Pediatric Acute-Onset Neuropsychiatric Disorders (PANS). Furthermore, we present the cases of five adolescents with PANS whose symptomatology increased following SARS-CoV-2 infection. What emerged from this study was that COVID-19 resulted in the exacerbation of obsessions, tics, anxiety and mood symptoms and decreased wellbeing. Moreover, new symptoms, as well as new PANS cases, are reported to have arisen after COVID-19 infection. Here, we hypothesize that the pathogenic mechanisms of silent viruses, such as the Epstein-Barr virus, are related to neuroinflammation, immune responses and reactivation, with additional roles played by social-isolation-related inflammatory processes. The discussion of PANS, which represents a model of immune-mediated neuropsychiatric manifestations, is particularly relevant, with the aim of uncovering the mechanisms that lead to neuropsychiatric Post-Acute COVID-19 Syndrome (PACS). Prospects for future studies and treatment implications are discussed.
新冠病毒病影响了全球所有人，常常导致长期的神经精神并发症。此外，社交距离、封锁措施以及对个人健康的担忧会使个体心理健康状况恶化，尤其是对儿童和青少年而言。在此，我们讨论了一些研究的结果，这些研究专门报告了有关新冠病毒病大流行或感染对患有儿童急性起病神经精神障碍（PANS）的儿童的影响的数据。此外，我们还介绍了5例患有PANS的青少年病例，他们在感染严重急性呼吸综合征冠状病毒2后症状加重。这项研究的结果显示，新冠病毒病导致强迫观念、抽动、焦虑和情绪症状加重，幸福感降低。此外，据报告，在感染新冠病毒病后出现了新的症状以及新的PANS病例。在此，我们推测，诸如爱泼斯坦-巴尔病毒等潜伏病毒的致病机制与神经炎症、免疫反应和再激活有关，社会隔离相关的炎症过程也起到了额外作用。对PANS的讨论尤为重要，因为它代表了一种免疫介导的神经精神表现模型，目的是揭示导致神经精神性新冠病毒病后急性综合征（PACS）的机制。文中还讨论了未来研究的前景和治疗意义。
