Abstract
Long-COVID refers to the lingering or protracted illness long after the acute illness. Depression, anxiety, fatigue, concentration and cognitive impairment appeared to be reported often in long COVID, psychosis seemed uncommon. Neuropsychiatric disorders in long COVID could be a consequence of direct viral insult on the central nervous system (CNS), continuous neuroinflammation, or neurodegeneration and metabolic impairment following the cerebral vascular accidents, or hypoxia from pulmonary damages and fibrotic changes. It is important to know how patients with various disorders, not only neuropsychiatric disorders, thrive under long COVID. How much the neuropsychiatric disorders reported in long COVID are stress related in nature, due to prolonged quarantine and social isolation, would also be important to study. Patients with diabetes are already known to have a higher risk of mortality and morbidity in COVID-19. How brain glucose metabolism may contribute to the neuropsychiatric symptoms in long COVID is an important area for COVID-19 research. Patients on psychotropics often asked their clinicians about potential conflicts of their medications with anti-COVID 19 vaccinations, or whether it would increase their vulnerability to COVID-19 viral infection. Thus, early reports of protective effects of psychotropics against COVID-19 need to be validated. Some antidepressant and antipsychotic agents indeed possess significant affinities for the sigma-1 and histamine receptors. This, with the earlier reports of reduced number of sigma-1 receptors in post- mortem schizophrenic brains and the reported roles of sigma and histamine receptors in neuroinflammation and viral infections, may point to an important and novel direction for drug discovery against COVID-19. Literature and data in all these areas are accumulating at a fast rate. We reviewed and discussed the relevant and important literature.
Tang, S., Leonard, B., & Helmeste, D. (2022). Long covid, neuropsychiatric disorders, psychotropics, present and future. Acta Neuropsychiatrica, 1-43. doi:10.1017/neu.2022.6 Published online by Cambridge University Press: 11 February 2022, pp. 1-43
