Emerging Knowledge of the Neurobiology of COVID-19

Matthew Butler; Benjamin Cross; Danish Hafeez; Mao Fong Lim; Hamilton Morrin; Emma Rachel Rengasamy; Tom Pollak; Timothy R Nicholson

doi:10.1016/j.psc.2021.11.001

Emerging Knowledge of the Neurobiology of COVID-19

Psychiatr Clin North Am. 2022 Mar;45(1):29-43. doi: 10.1016/j.psc.2021.11.001. Epub 2021 Nov 11.

Authors

Matthew Butler¹, Benjamin Cross², Danish Hafeez³, Mao Fong Lim⁴, Hamilton Morrin⁵, Emma Rachel Rengasamy⁶, Tom Pollak⁷, Timothy R Nicholson⁷

Affiliations

¹ Institute of Psychiatry, Psychology and Neuroscience, King's College, 16 De Crespigny Park, SE5 8AF London. Electronic address: Matthew.butler@kcl.ac.uk.
² East Lancashire Hospitals NHS Trust, Casterton Ave, Burnley, BB10 2PQ.
³ School of Medical Sciences, The University of Manchester, Oxford Rd, Manchester, M13 9PL, UK.
⁴ Cambridge University Hospitals NHS Foundation Trust, Hills Rd, Cambridge, CB2 0QQ, UK.
⁵ Maidstone & Tunbridge Wells NHS Trust, Tonbridge Rd, Royal Tunbridge Wells, TN2 4QJ, UK.
⁶ Cwm Taf Morgannwg University Health Board, Ynysmeurig House, Navigation Park, Abercynon, CF45 4SN, UK.
⁷ Institute of Psychiatry, Psychology and Neuroscience, King's College, 16 De Crespigny Park, SE5 8AF London.

Abstract

Many patients with COVID-19 will experience acute or longer-term neuropsychiatric complications. The neurobiological mechanisms behind these are beginning to emerge; however, the neurotropic hypothesis is not strongly supported by clinical data. The inflammatory response to SARS-CoV-2 is likely to be responsible for delirium and other common acute neuropsychiatric manifestations. Vascular abnormalities such as endotheliopathies contribute to stroke and cerebral microbleeds, with their attendant neuropsychiatric sequelae. Longer-term neuropsychiatric syndromes fall into 2 broad categories: neuropsychiatric deficits occurring after severe (hospitalized) COVID-19 and "long COVID," which occurs in many patients with a milder acute COVID-19 illness.

Keywords: COVID-19; Delirium; Long COVID; Neurobiology; Neuropsychiatry; SARS-CoV-2.

Publication types

Review

MeSH terms

COVID-19* / complications
Humans
Nervous System Diseases / virology*
Neurobiology
Post-Acute COVID-19 Syndrome
SARS-CoV-2