The Pathogenesis of Long-Term Neuropsychiatric COVID-19 and the Role of Microglia, Mitochondria, and Persistent Neuroinflammation, 2021, Stefano et al

M

Milo

Senior Member (Voting Rights)
Full title:
Editorial: The Pathogenesis of Long-Term Neuropsychiatric COVID-19 and the Role of Microglia, Mitochondria, and Persistent Neuroinflammation: A Hypothesis (2021) Stefano et al.

Abstract:

Persistent comorbidities occur in patients who initially recover from acute coronavirus disease 2019 (COVID-19) due to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

'Long COVID' involves the central nervous system (CNS), resulting in neuropsychiatric symptoms and signs, including cognitive impairment or 'brain fog' and chronic fatigue syndrome.

There are similarities in these persistent complications between SARS-CoV-2 and the Ebola, Zika, and influenza A viruses.

Normal CNS neuronal mitochondrial function requires high oxygen levels for oxidative phosphorylation and ATP production.

Recent studies have shown that the SARS-CoV-2 virus can hijack mitochondrial function.

Persistent changes in cognitive functioning have also been reported with other viral infections. SARS-CoV-2 infection may result in long-term effects on immune processes within the CNS by causing microglial dysfunction.

This short opinion aims to discuss the hypothesis that the pathogenesis of long-term neuropsychiatric COVID-19 involves microglia, mitochondria, and persistent neuroinflammation

Link to abstract here
 
Last edited by a moderator:
Is it just me having problems with the term ‘neuropsychiatric’ as opposed to ‘neuropsychological’?

For me the former is suggesting more than just such as cognitive and/or sensory issues, rather straying in to the realm of mental health. Surely this should be the realm of the neurologist and the neuropsychologist rather than the psychiatrist and the psychiatric disorders oriented clinical psychologist. Unfortunately from just the abstract, even though they mention concrete neurological issues, it is hard to know if they are intending this interpretation or not.
 
Why not just neurlogical. Is there evidence of any psychiatric or psychological symptoms in long Covid? Brain fog, loss of sense of taste and smell, possibly things like headache and other pain, if they originate in the brain, are surely neurological problems.

I would only class a symptom as psychiatric or psychological if it directly influences mood or personality or connection with reality, or behaviours resulting from those, not if it simply originates in the brain and produces cognitive or physical symptoms.

Even things like sadness or anger or distress at loss of occupation and at feeling wretched are natural outcomes of the combination of having a horrible new set of physical and cognitive symptoms, especially when surrounded by disbelief and lack of support. I don't see them as direct biological outcomes of the ongoing illness, more as repurcussions of being so sick.
 
Trish said:
I would only class a symptom as psychiatric or psychological if it directly influences mood or personality or connection with reality, or behaviours resulting from those, not if it simply originates in the brain and produces cognitive or physical symptoms.
Click to expand...

Technically neuropsychology looks specifically at issues like cognitive function, the mechanics of perception, language production, taste, hunger, etc as distinct from mood or personality, though clinical psychologists may individually deal with both they are effectively very different disciplines. Unfortunately there seem to be very few neuropsychologists about, especially in areas of interest to ourselves.
 
Neuropsychiatric, as opposed to psychiatric is probably most commonly used to indicate changes in mental activities associated with known metabolic, toxic, inflammatory or degenerative disorders. So it would be used for hypothyroidism, alcoholism, Alzheimer's, Parkinson's, MS. It would cover things like memory loss, inability to think clearly, as well as emotional changes or abnormal behaviours.

Perhaps paradoxically neuropsychiatric is a much more 'physical' notion than psychological. Neuropsychology has two uses, one mostly used for developmental problems in children (clinical) and the other for basic research into things like perception (non-clinical). I would not expect this study to use neuropsychological. As indicated neuropsychiatric has a much more 'physical' feel.
 
Milo said:
Full title:
This short opinion aims to discuss the hypothesis that the pathogenesis of long-term neuropsychiatric COVID-19 involves microglia, mitochondria, and persistent neuroinflammation
Click to expand...
I haven't gotten to look into the details yet, but at a glance this makes me think of Jarred Younger and his research into ME and fibro. He's gotten a grant to look for neuroinflammation in ME recently (from the NIH I think?), and I read once about his idea that "hyperactive"/"angry" microglia that overreact to every little thing could be a mechanism of action in ME.

Edit: Found a link to Youngers project regarding this. It could be interesting, in my view. Hoping something interpretable comes out of it.
 
Last edited:
First paragraph: ...."initially recover"...

The term "recover" from COVID rankles with me. Perhaps technically recovered if this virus is no longer detectable with the level of testing we have available. Or, perhaps it is definitely gone. I don't think we really know with a number of diseases that follow viruses, if the initiating infection is actually gone.

Even if medical technology is right in many situations, and the initiating disease is truly gone, it can be demoralizing to be told you've recovered, but continue to be very affected by debilitating symptoms. One's mental health comes under more intense scrutiny, and alterior motives are suspected.
 
You must log in or register to reply here.
Back
Top Bottom