COVID-19-Induced Brain and Spinal Cord Injury May Drive Neurological and Psychiatric Complications

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COVID-19 correlates with higher inflammation associated blood protein levels and immune system imbalances linked to psychiatric problems like depression and anxiety.

Image by PIRO4D from Pixabay

Written by Brett J. Weiss

03-21-2021

Highlights

  • COVID-19 patients have a higher incidence of anxiety and depression.
  • Patients with psychiatric complications have elevated inflammation-associated blood proteins.
  • Depressed COVID-19 patients show an imbalanced immune response.

Most of us know that COVID-19 adversely impacts the lungs and can cause a fever and stomach problems, but COVID-19 patients also show troubling neurological and psychiatric issues. Such issues suggest varying degrees of brain damage, so finding out how the SARS-CoV2 virus that causes COVID-19 and the infection itself impacts the brain is crucial for brain preservation in patients.

Hu and colleagues from Zhejiang University in China published a study in the European Archives of Psychiatry and Clinical Neuroscience showing higher incidences of depression and anxiety in COVID-19 patients. Some of the more uncommon COVID-19-related complications include hallucinations, paranoia, agitation and aggression. Higher patient blood markers for inflammation and immune cell imbalances correlate with psychiatric problems, possibly providing clues to how the viral infection damages the brain. These findings may help in the development of future therapeutic options to mitigate COVID-19’s effects on the brain.

How Does the SARS-CoV2 Virus Enter the Body?

The angiotensin-converting enzyme 2 (ACE2) receptor plays a key role in mediating the SARS-CoV2 virus invasion into cells. It’s present in the mucus membrane of the respiratory and digestive tracts, and viral passage through the receptor results in multiple organ damage, including the brain and spial column.

COVID-19 Patients Have a Higher Psychiatric Ailment Incidence

To get a better idea of psychiatric problem prevalence in COVID-19 patients, Hu and colleagues neurologically and psychiatrically evaluated 77 patients with COVID-19. 52.3% of the patients displayed anxiety, 47.7% showed depression, 2.6% had paranoia, and 1.3% experienced hallucinations. These findings suggest that COVID-19 has adverse effects on the brain.

COVID-19 Patients with Psychiatric Problems Have Higher Blood Inflammation Factor Levels

COVID-19 patients have increased blood proteins indicative of inflammation, but whether COVID-19-induced inflammation plays a role in psychiatric complication onset has remained unclear. Hu and colleagues found that patients with psychiatric complications have significantly higher levels of the inflammatory factor interleukin-6. This finding indicates that psychiatric problems in COVID-19 patients are associated with increased levels of blood proteins indicative of inflammation.

(He et al., 2021 | European Archives of Psychiatry and Clinical Neuroscience) COVID-19 patients exhibiting anxiety or depression have higher inflammatory marker interleukin-6 levels. The table presents the total number of patients in the left column, the patients with or without complications in the middle column, and the patients with psychiatric symptoms in the right column. Each row consists of the values for each inflammation-associated blood protein. The far-right column gives the p-value. Patients with psychiatric complications had higher interleukin-6 and interleukin-10 inflammatory protein levels in their blood.

Depressed COVID-19 Patients Show an Immune Cell Imbalance

Previous studies have indicated an imbalanced immune response in COVID-19 patients, so Hu and colleagues sought to determine whether this type of imbalance correlates with psychiatric symptoms. They found that patients presenting with moderate depression have elevated immune response imbalances as indicated by a reduced CD4+ to CD8+ immune cell ratio. This means that COVID-19 associated immune system imbalances are linked with depression onset. According to Hu and colleagues, it may also indicate an overactive immune response, possibly driving depression. Figuring out how an overactive immune response may promote depression requires further research.

“To the best of our knowledge, this study is the first to investigate both the neurological and psychiatric presentations in patients with COVID-19,” stated Hu ad colleagues. “Our findings suggest that more attention paid to neurological and psychiatric presentations in patients with COVID-19.”

Future Research on COVID-19 and Psychiatric Problems May Improve Therapeutic Options

Since we are at the tip of the iceberg in figuring out how COVID-19 may lead to brain and spinal column injury to trigger psychiatric problems, further research is required. Maybe identifying the pathways by which COVID-19 drives these complications will lead to therapeutic options to preserve brain function in patients or restore it in those who have recovered.

Story Source

He X, Zhang D, Zhang L, Zheng X, Zhang G, Pan K, Yu H, Zhang L, Hu X. Neurological and psychiatric presentations associated with COVID-19. Eur Arch Psychiatry Clin Neurosci. 2021 Mar 12:1–12. doi: 10.1007/s00406-021-01244-0. Epub ahead of print. PMID: 33710424; PMCID: PMC7953372.

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