COVID-19 and post-traumatic stress disorder: The perfect 'storm' for mental health (Review)

Ioanna Giannopoulou, Sofia Galinaki, Evangelia Kollintza, Maria Adamaki, Stylianos Kympouropoulos, Evangelos Alevyzakis, Konstantinos Tsamakis, Iraklis Tsangaris, Demetrios A Spandidos, Nikolaos Siafakas, Vassilios Zoumpourlis, Emmanouil Rizos, Ioanna Giannopoulou, Sofia Galinaki, Evangelia Kollintza, Maria Adamaki, Stylianos Kympouropoulos, Evangelos Alevyzakis, Konstantinos Tsamakis, Iraklis Tsangaris, Demetrios A Spandidos, Nikolaos Siafakas, Vassilios Zoumpourlis, Emmanouil Rizos

Abstract

Since its outbreak, in December, 2019, in the Chinese city of Wuhan, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has evolved into an ongoing global pandemic. Due to the novel antigenic properties of this virus, the world population could not develop immunity effectively and this led to the subsequent spread of COVID-19. This caused an unprecedented emergency situation with significant negative effects on health and well-being both on an individual and societal level. Apart from health, economic and social consequences, the impact of this pandemic on mental health is increasingly being reported in the scientific literature. The present review aimed to provide a comprehensive discussion of the possible neurological and neuropsychiatric manifestations of SARS-CoV-2, together with the related underlying molecular pathways. In addition, the present review focused on populations which are at a higher risk of developing psychiatric disturbances due to the COVID-19 pandemic and discussed possible routes of clinical management and therapeutics to minimize the burden associated with psychiatric disorders. Moreover, research findings exploring the prevalence of COVID-19-related post-traumatic stress disorder (PTSD) symptoms across vulnerable groups, including children, adolescents and COVID-19 survivors are presented, with particular emphasis on those with severe disease who required hospitalization and/or intensive care unit admission. Based on the available literature, the identification of potential determinants associated with PTSD across the different populations is underlined. Lessons learnt from the pandemics across the globe together with the ongoing research on COVID-19 and its impact on mental health, highlight the utmost importance for evidence-based, proactive and targeted interventions in high-risk groups aiming to mitigate the risks and manage vulnerabilities.

Keywords: COVID-19; SARS-CoV-2 neurobiology; mental health; post-traumatic stress disorder; trauma.

Conflict of interest statement

DAS is the Editor-in-Chief for the journal, but had no personal involvement in the reviewing process, or any influence in terms of adjudicating on the final decision, for this article. The other authors declare that they have no competing interests.

Copyright: © Giannopoulou et al.

Figures

Figure 1
Figure 1
Postulated pathways for SARS-CoV-2 CNS invasion. SARS-CoV-2 can use both direct and indirect pathways to invade the brain. BBB, blood-brain barrier; BCSFB, blood-cerebrospinal fluid barrier; ACE2, angiotensin converting enzyme 2. The figure was adapted from the study by Rege (25).

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