Past pandemics indicate that those recovering from COVID-19 infections may face a host of mental disorders going forward. These include mood swings, insomnia, anxiety, depression, mania, suicidal tendencies, and delirium, according to a new article posted in the journal ‘Brain, Behavior, and Immunity’.
Past pandemics, according to the study, have demonstrated that diverse types of neuropsychiatric symptoms (mental disorders) such as encephalopathy, mood changes, psychosis, neuromuscular dysfunction or demyelinating processes, may accompany acute viral infection.
Encephalopathy is a broad term for any insult that alters brain function or structure, and therefore one’s mental status. Demyelination is loss of the protective myelin sheathing of nerve cells, resulting in neurological problems.
These symptons may also “follow infection by weeks, months, or longer in recovered patients,” note senior author Suzi Hong and co-authors Dr. Emily Troyer, and Jordan Kohn–all researchers from the University of California San Diego School of Medicine.
Lessons from the past
The authors note that studies of past respiratory viral pandemics indicate that diverse types of neuropsychiatric symptoms can arise. These include an increased incidence of insomnia, anxiety, depression, mania, suicidal tendencies, and delirium, which followed influenza pandemics in the 18th and 19th centuries.
“Encephalitis lethargica is an inflammatory disorder of the CNS marked by hypersomnolence (abnormal sleepiness), psychosis, catatonia, and Parkinsonism. Incidence increased around the time of the 1918 pandemic,” said the authors.
During more recent viral outbreaks, such as SARS-CoV-1 in 2003, H1N1 in 2009, and MERS-CoV in 2012, there were subsequent reports of higher rates of narcolepsy, seizures, encephalitis (brain inflammation), Guillain-Barre syndrome and other neuromuscular and demyelinating conditions.
Current situation
“Reports are already surfacing of acute CNS-associated symptoms in individuals affected by COVID-19,” said Hong, including greater stroke incidence in severely infected patients in Wuhan, China, along with delirium and loss of smell and taste senses.
(A survey of UC San Diego Health patients treated for COVID-19, published April 12, 2020 issue of International Forum of Allergy & Rhinology, described the first empirical findings strongly associating sensory loss with COVID-19. The loss was temporary, said the authors, with taste and smell returning within two to four weeks of infection.)
Hong, Troyer and Kohn say the neuropsychiatric consequences of the current novel coronavirus pandemic are not yet known, but likely will be significant and last for years.
“We will need to do this at different points in their lives, for years to come, to fully appreciate this pandemic’s effects on neuropsychiatric outcomes for differing age groups, and how to better prepare for pandemics to come,” Hong said.
The researchers, however, qualified that, “Our article seeks to bring the medical community’s attention to the need for monitoring and investigations to mitigate such outcomes, not to cause panic among individuals whose lives are already greatly affected by this pandemic.”
