Interaction of somatic findings and psychiatric symptoms in COVID-19. Ascoping review

Abstract

An infection with SARS-CoV‑2 can affect the central nervous system, leading to neurological as well as psychiatric symptoms. In this respect, mechanisms of inflammation seem to be of much greater importance than the virus itself. This paper deals with the possible contributions of organic changes to psychiatric symptomatology and deals especially with delirium, cognitive symptoms, depression, anxiety, posttraumatic stress disorder and psychosis. Processes of neuroinflammation with infection of capillary endothelial cells and activation of microglia and astrocytes releasing high amounts of cytokines seem to be of key importance in all kinds of disturbances. They can lead to damage in grey and white matter, impairment of cerebral metabolism and loss of connectivity. Such neuroimmunological processes have been described as aorganic basis for many psychiatric disorders, as affective disorders, psychoses and dementia. As the activation of the glia cells can persist for along time after the offending agent has been cleared, this can contribute to long term sequalae of the infection.