Kowalski Krzysztof, Misiak Błażej
Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland.
Department of Psychiatry, Wroclaw Medical University, Pasteura 10 Street, 50-367 Wroclaw, Poland.
Rev Psiquiatr Salud Ment. 2023 Jul 8. doi: 10.1016/j.rpsm.2023.04.002.
The outbreak of the Coronavirus Disease 2019 (COVID-19) pandemic in 2020 caused a rapid worsening of global mental health. Patients with severe mental disorders, including schizophrenia, are at higher risk of being infected. The neuroinvasive potential of the severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has been confirmed. The aim of this article was to present a narrative and comprehensive review of multidimensional associations between schizophrenia and COVID-19 with special emphasis on common biological pathways. Online searches were performed in the PubMed database and covered the publication period until September 17, 2022. Search terms included "psychosis", "schizophrenia", "inflammation" and "COVID-19". Viewed as a neuroinflammatory state, schizophrenia shares several neurobiological mechanisms with the COVID-19. Environmental stress, common comorbidities of schizophrenia and adverse effects of antipsychotic treatment are associated with the higher severity and mortality of the COVID-19. Additionally, more frequent relapses of psychosis have been observed, and might be related to lower treatment adherence. In the context of clinical manifestation, higher level of negative symptoms has been identified among patients with schizophrenia during the pandemic. Improvements in mental health care policy and treatment adjustment are necessary to protect people with schizophrenia who are the population that is particularly vulnerable to the consequences of the COVID-19 pandemic. Future research will show if prenatal infection with the SARS-CoV-2 increases a risk of psychosis.
2020年新型冠状病毒肺炎（COVID-19）大流行的爆发导致全球心理健康迅速恶化。包括精神分裂症在内的严重精神障碍患者感染风险更高。严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）的神经侵袭潜力已得到证实。本文旨在对精神分裂症与COVID-19之间的多维度关联进行叙述性综合综述，特别强调共同的生物学途径。在PubMed数据库中进行了在线搜索，涵盖截至2022年9月17日的发表期。搜索词包括“精神病”“精神分裂症”“炎症”和“COVID-19”。精神分裂症被视为一种神经炎症状态，与COVID-19有几种神经生物学机制相同。环境压力、精神分裂症的常见共病以及抗精神病药物治疗的不良反应与COVID-19的更高严重程度和死亡率相关。此外，已观察到精神病复发更频繁，这可能与治疗依从性较低有关。在临床表现方面，在大流行期间，精神分裂症患者中阴性症状水平较高。改善精神卫生保健政策和调整治疗对于保护精神分裂症患者是必要的，这些患者是特别容易受到COVID-19大流行后果影响人群。未来的研究将表明，产前感染SARS-CoV-2是否会增加患精神病的风险。
