Introduction
During the early stage of COVID-19, in addition to the typical symptoms like fever, cough, sore throat, and difficulty breathing, people may also experience certain neuropsychiatric symptoms. These neuropsychiatric symptoms can include a reduced or complete loss of smell (hyposmia/anosmia), disturbances in consciousness, confusion, restlessness, brain inflammation, brain dysfunction (encephalopathy), brain swelling (encephalitis), sudden blockage of blood vessels in the brain (acute ischemic stroke), brain damage caused by lack of oxygen or reduced blood flow (hypoxic/ischemic brain injury), seizures, dizziness, tingling or abnormal sensations (numbness or paresthesia), increased anxiety, depression, and insomnia (trouble sleeping).
Additionally, in some cases, new-onset psychosis, a condition characterized by a loss of touch with reality, has been observed during the acute phase of COVID-19 infection. However, scientific evidence is growing to suggest that many individuals who have recovered from COVID-19 continue to experience various neuropsychiatric symptoms that last for months or may even emerge after the initial infection. This article will emphasize the mental disorders that occur after COVID-19.
What Are Post-COVID Psychiatric Problems?
Post-COVID psychiatric problems refer to the mental health issues that individuals may experience following a COVID-19 infection. Depression and anxiety are the most commonly reported psychiatric symptoms in individuals experiencing long-lasting effects of COVID-19. It has been observed that a significant proportion of COVID-19 patients, including those who were critically ill and required intensive care, develop anxiety and mood disorders within six months of their COVID-19 diagnosis. These symptoms can persist for several months after hospital discharge. Women tend to be more likely than men to experience anxiety and low mood in relation to recovery after COVID. Factors such as the severity of the disease, hospitalization, and pre-existing mental health conditions may contribute to the presence of anxiety and depression symptoms in COVID-affected individuals.
What Are Neuropsychiatric Disorders After COVID?
Various studies highlight the presence of long-lasting neuropsychiatric symptoms in individuals who have recovered from COVID-19. These include depression, anxiety, post-traumatic stress disorder (PTSD), sleep disturbances, fatigue, and cognitive deficits. Even after six months, a significant proportion of hospitalized COVID-19 patients report these symptoms, with fatigue and sleep disturbances being the most common. While most individuals recover physically and functionally within a year, their overall health status remains lower compared to those without COVID-19. Notably, patients who require intensive care often have a higher incidence of neurological or psychiatric conditions within six months.
Post-traumatic stress disorder (PTSD) can occur in individuals experiencing the long-term effects of COVID-19. Similar to past outbreaks like SARS (severe acute respiratory syndrome) and MERS (middle east respiratory syndrome), survivors of COVID-19 have shown elevated rates of PTSD that persist for several months. Symptoms of PTSD have been observed within the first month after hospitalization, with some patients experiencing a decrease in symptoms over time.
Factors such as the severity and duration of physical symptoms, as well as psychological distress during hospitalization, can contribute to the development of PTSD in individuals with long COVID. Women have been found to be more susceptible to COVID-19-related PTSD compared to men. The type of care received (such as ICU or general ward) and pre-existing mental health conditions may also influence the risk of developing PTSD. However, the association between PTSD and factors like body mass index (BMI) and physical health issues remains inconclusive. Other factors that may influence the severity of PTSD symptoms include previous traumatic experiences, persistent COVID-19 symptoms, feelings of stigma, and negative perceptions of the pandemic.
Sleep disturbances and fatigue are common among COVID-19 survivors and can significantly impact their quality of life. These symptoms may range in severity and can be debilitating for some individuals. In addition to sleep difficulties and fatigue, other neuropsychiatric symptoms associated with long COVID include memory impairment, concentration difficulties, headaches, disorientation or confusion, and obsessive-compulsive symptoms.
Why Do Disorders Occur Following Recovery From COVID-19?
After a person recovers from COVID-19, some individuals may experience neuropsychiatric symptoms, such as problems with their mental health or brain function. Researchers have made progress in understanding why these symptoms occur.
Coronaviruses, including the one that causes COVID-19, have the ability to affect the nervous system. However, it is not completely clear how the virus enters the nervous system. Studies in animals suggest that the virus may travel backward along certain nerve pathways or cross a protective barrier called the blood-brain barrier.
The virus can also enter cells directly by attaching to a specific receptor called ACE2, which is found in different parts of the brain and other neural tissues. This attachment triggers an immune response, where the infected cells release certain proteins called cytokines. These cytokines can cause inflammation and affect brain function.
One specific cytokine called IL-6 seems to play a significant role in the inflammatory response caused by the virus. The excessive release of cytokines, including IL-6, can disrupt the normal functioning of the brain and lead to neuropsychiatric symptoms.
Therefore, COVID-19 can affect the nervous system by entering through different routes and triggering an immune response. The release of cytokines, particularly IL-6, can cause inflammation and affect brain function, resulting in neuropsychiatric symptoms.
How Does COVID Impact Mental Health?
Understanding the exact reasons why prolonged COVID can impact mental health requires further research. However, here are some possible connections that have been observed:
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Lingering physical symptoms of prolonged COVID can persist with no clear end in sight, and dealing with a prolonged illness increases the risk of depression.
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Certain individuals with COVID may face difficulties in returning to work or socializing due to symptoms like confusion. This prolonged isolation and disruption to daily life can contribute to mental health conditions.
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Anxiety may be associated with COVID, particularly if individuals experience distressing physical symptoms such as breathing difficulties. Concerns about the long-term effects of COVID and the possibility of symptoms never going away can also contribute to anxiety.
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Traumatic experiences during hospitalization or intensive care unit stay, which some long COVID patients have gone through, can lead to anxiety, confusion, and even post-traumatic stress disorder (PTSD).
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Insomnia, confusion, and a sense of not being back to one's normal self after recovering from COVID can also impact mental well-being among COVID patients.
Conclusion
To conclude, individuals recovering from COVID may experience a range of symptoms, including sleep disturbances, fatigue, and other neuropsychiatric symptoms. These symptoms can persist for several months after the initial infection and can have a significant impact on the individual's daily life and well-being.
