Some psychiatric and neurological aspects of the asymptomatic and mild course of COVID-19

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OBJECTIVE

To study neurological and mental disorders associated with the inapparent and mild course of COVID-19.

MATERIAL AND METHODS

The study included 50 patients (mean age 35.2±11.4 years) admitted to a psychiatric hospital due to depressive spectrum disorders. Patients were divided into two groups: patients (n=16) who had IgG antibodies to SARS-CoV-2 (main group) and patients (n=34) without a history of COVID-19 (comparison group).

RESULTS AND CONCLUSION

Patients of the main group showed a difference in the structure of asthenic disorders compared with the comparison group. Also, there was a significant predominance of the severity of asthenic symptoms and anxiety in the structure of psychopathological disorders in depressive spectrum disorders. The viral intoxication contributes to the formation of a kind of asthenic «soil» (with characteristic manifestations). In the future, in the case of the development of any stress-associated disorder, more pronounced psychopathological disorders are noted compared with patients of the comparison group. The authors describe a variant of the course of COVID-19, in which the development of ischemic stroke was the first clinical manifestation of the disease. These disorders are based on the pronounced neurotropic effect of SARS-CoV-2 and its effect on the neurovascular unit.

Keywords:

neurological disorders

psychopathological symptoms

COVID-19

mild course

neurotropic effect

Authors:

Chritinin D.F.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0001-9107-2357

Shamrey V.K.

Kirov Military Medical Academy

ORCID: 0000-0002-1165-6465

Kurasov E.S.

Kirov Military Medical Academy

ORCID: 0000-0003-3616-6574

Litvinenko I.V.

Kirov Military Medical Academy

SPIN RSCI: 6112-2792
Scopus AuthorID: 35734354000
ResearcherID: F-9120-2013
ORCID: 0000-0001-8988-3011

Tsygan N.V.

Kirov Military Medical Academy;
Konstantinov Peterburg Institute of Nuclear Physics of the National Research Center «Kurchatov Institute»

SPIN RSCI: 1006-2845
Scopus AuthorID: 37066611200
ResearcherID: H-9132-2016
ORCID: 0000-0002-5881-2242

Golokhvastov S.Yu.

Kirov Military Medical Academy

Ryabtsev A.V.

Kirov Military Medical Academy;
Konstantinov Petersburg Institute of Nuclear Physics of the National Research Center «Kurchatov Institute»;
National Research Center «Kurchatov Institute»

Received:

09.09.2021

Accepted:

15.09.2021

List of references:

Li X, Xu S, Yu M, Wang K, Tao Y, Zhou Y, Shi J, Zhou M, Wu B, Yang Z, Zhang C, Yue J, Zhang Z, Renz H, Liu X, Xie J, Xie M, Zhao J. Risk factors for severity and mortality in adult COVID-19 inpatients in Wuhan. J Allergy Clin Immunol. 2020;146(1):110-118. PMID: 32294485. https://doi.org/10.1016/j.jaci.2020.04.006
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, Wang B, Xiang H, Cheng Z, Xiong Y, Zhao Y, Li Y, Wang X, Peng Z. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus — Infected Pneumonia in Wuhan, China. JAMA. 2020;323(11):1061-1069.. PMID: 32031570. https://doi.org/10.1001/jama.2020.1585
Noymer A, Carreon D, Johnson N. Questioning the salicylates and influenza pandemic mortality hypothesis in 1918—1919. Clin Infect Dis. 2010;15;50(8):1203.
Rogers J, Chesney E, Oliver D, Pollak Th. Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. Lancet. 2020;7:611.
Mao L, Jin H, Wang M, Hu Y, Chen S, He Q, Chang J, Hong C, Zhou Y, Wang D, Miao X, Li Y, Hu B. Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China. JAMA Neurology. 2020;77(6):683-690. https://doi.org/10.1001/jamaneurol.2020.1127
Vaira LA, Salzano G, Riu GD. The importance of olfactory and gustatory disorders as early symptoms of coronavirus disease (COVID-19). Br J Oral Maxillofac Surg. 2020;58(5):615-616. PMID: 32362452. https://doi.org/10.1016/j.bjoms.2020.04.024
Lechien JR, Chiesa‐Estomba CM, Place S, Laethem YV, Cabaraux P, Mat Q, Huet K, Plzak J, Horoi M, Hans S, Barillari MR, Cammaroto G, Fakhry N, Martiny D, Ayad T, Jouffe L, Hopkins C, Saussez S. Clinical and epidemiological characteristics of 1420 European patients with mild-to-moderate coronavirus disease 2019. J Intern Med. 2020;288(3):335-344. PMID: 32352202. https://doi.org/10.1111/joim.13089
Zhao XY, Xu XX, Yin HS, Hu QM, Xiong T, Tang YY, Yang AY, Yu BP, Huang ZP. Clinical characteristics of patients with 2019 coronavirus disease in a non-Wuhan area of Hubei Province, China: a retrospective study. BMC Infect Dis. 2020;20(1):311. PMID: 32345226. https://doi.org/10.1186/s12879-020-05010-w
Garg S. Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1—30, 2020. MMWR. Morb Mortal Wkly Rep. 2020;69. PMID: 32298251. https://doi.org/10.15585/mmwr.mm6915e3
Kujawski SA, Wong KK, Collins JP, Epstein L, Killerby ME, Midgley CM, Abedi GR, Ahmed NS, Almendares O, Alvarez FN, Anderson KN, Balter S, Barry V, Bartlett K, Beer K, Ben-Aderet MA, Benowitz I, Biggs HM, Binder AM, Black SR, Bonin B, Bozio CH, Brown CM, Bruce H, Bryant-Genevier J, Budd A, Buell D, Bystritsky R, Cates J, Charles EM, Chatham-Stephens K, Chea N, Chiou H, Christiansen D, Chu V, Cody S, Cohen M, Conners EE, Curns AT, Dasari V, Dawson P, DeSalvo T, Diaz G, Donahue M, Donovan S, Duca LM, Erickson K, Esona MD, Evans S, Falk J, Feldstein LR, Fenstersheib M, Fischer M, Fisher R, Foo C, Fricchione MJ, Friedman O, Fry A, Galang RR, Garcia MM, Gerber SI, Gerrard G, Ghinai I, Gounder P, Grein J, Grigg C, Gunzenhauser JD, Gutkin GI, Haddix M, Hall AJ, Han GS, Harcourt J, Harriman K, Haupt T, Haynes AK, Holshue M, Hoover C, Hunter JC, Jacobs MW, Jarashow C, Joshi K, Kamali T, Kamili S, Kim L, Kim M, King J, Kirking HL, Kita-Yarbro A, Klos R, Kobayashi M, Kocharian A, Komatsu KK, Koppaka R, Layden JE, Li Y, Lindquist S, Lindstrom S, Link-Gelles R, Lively J, Livingston M, Lo K, Lo J, Lu X, Lynch B, Madoff L, Malapati L, Marks G, Marlow M, Mathisen GE, McClung N, McGovern O, McPherson TD, Mehta M, Meier A, Mello L, Moon S, Morgan M, Moro RN, Murray J, Murthy R, Novosad S, Oliver SE, O’Shea J, Pacilli M, Paden CR, Pallansch MA, Patel M, Patel S, Pedraza I, Pillai SK, Pindyck T, Pray I, Queen K, Quick N, Reese H, Reporter R, Rha B, Rhodes H, Robinson S, Robinson P, Rolfes MA, Routh JA, Rubin R, Rudman SL, Sakthivel SK, Scott S, Shepherd C, Shetty V, Smith EA, Smith S, Stierman B, Stoecker W, Sunenshine R, Sy-Santos R, Tamin A, Tao Y, Terashita D, Thornburg NJ, Tong S, Traub E, Tural A, Uehara A, Uyeki TM, Vahey G, Verani JR, Villarino E, Wallace M, Wang L, Watson JT, Westercamp M, Whitaker B, Wilkerson S, Woodruff RC, Wortham JM, Wu T, Xie A, Yousaf A, Zahn M, Zhang J. Clinical and virologic characteristics of the first 12 patients with coronavirus disease 2019 (COVID-19) in the United States. Nat Med. 2020;26(6):861-868. PMID: 32327757. https://doi.org/10.1038/s41591-020-0877-5
Zheng S, Fan J, Yu F, Feng B, Lou B, Zou Q, Xie G, Lin S, Wang R, Yang X, Chen W, Wang Q, Zhang D, Liu Y, Gong R, Ma Z, Lu S, Xiao Y, Gu Y, Zhang J, Yao H, Xu K, Lu X, Wei G, Zhou J, Fang Q, Cai H, Qiu Y, Sheng J, Chen Y, Liang T. Viral load dynamics and disease severity in patients infected with SARS-CoV-2 in Zhejiang province, China, January—March 2020: retrospective cohort study. BMJ. 2020;369. PMID: 32317267. https://doi.org/10.1136/bmj.m1443
Chen R, Liang W, Jiang M, Guan W, Zhan C, Wang T, Tang C, Sang L, Liu J, Ni Z, Hu Y, Liu L, Shan H, Lei C, Peng Y, Wei L, Liu Y, Hu Y, Peng P, Wang J, Liu J, Chen Z, Li G, Zheng Z, Qiu S, Luo J, Ye C, Zhu S, Liu X, Cheng L, Ye F, Zheng J, Zhang N, Li Y, He J, Li S, Zhong N. Risk Factors of Fatal Outcome in Hospitalized Subjects With Coronavirus Disease 2019 From a Nationwide Analysis in China. Chest. 2020;158(1):97-105. PMID: 32304772. https://doi.org/10.1016/j.chest.2020.04.010
Yu X, Sun X, Cui P, Pan H, Lin S, Han R, Jiang C, Fang Q, Kong D, Zhu Y, Zheng Y, Gong X, Xiao W, Mao S, Jin B, Wu H, Fu C. Epidemiological and clinical characteristics of 333 confirmed cases with coronavirus disease 2019 in Shanghai, China. Transbound Emerg Dis. 2020;67(4):1697-1707. PMID: 32351037. https://doi.org/10.1111/tbed.13604
Feng Y, Ling Y, Bai T, Xie Y, Huang J, Li J, Xiong W, Yang D, Chen R, Lu F, Lu Y, Liu X, Chen Y, Li X, Li Y, Summah HD, Lin H, Yan J, Zhou M, Lu H, Qu J. COVID-19 with Different Severities: A Multicenter Study of Clinical Features. Am J Respir Crit Care Med. 2020;201(11):1380-1388. PMID: 32275452. https://doi.org/10.1164/rccm.202002-0445OC
Beltrán-Corbellini Á, Chico-García JL, Martínez-Poles J, Rodríguez-Jorge F, Natera-Villalba E, Gómez-Corral J, Gómez-López A, Monreal E, Parra-Díaz P, Cortés-Cuevas JL, Galán JC, Fragola-Arnau C, Porta-Etessam J, Masjuan J, Alonso-Cánovas A. Acute-onset smell and taste disorders in the context of COVID-19: a pilot multicentre polymerase chain reaction based case — control study. Eur J Neurol. 2020;27(9):1738-1741. PMID: 32449247. https://doi.org/10.1111/ene.14273
Lechien JR, Chiesa-Estomba CM, De Siati DR, Horoi M, Le Bon SD, Rodriguez A, Dequanter D, Blecic S, El Afia F, Distinguin L, Chekkoury-Idrissi Y, Hans S, Delgado IL, Calvo-Henriquez C, Lavigne P, Falanga C, Barillari MR, Cammaroto G, Khalife M, Leich P, Souchay C, Rossi C, Journe F, Hsieh J, Edjlali M, Carlier R, Ris L, Lovato A, De Filippis C, Coppee F, Fakhry N, Ayad T, Saussez S. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur arch Otorhinolaryngol. 2020;277(8):2251-2261. PMID: 32253535. https://doi.org/10.1007/s00405-020-05965-1
Godaert L, Proye E, Demoustier-Tampere D, Coulibaly PS, Hequet F, Dramé M. Clinical characteristics of older patients: The experience of a geriatric short-stay unit dedicated to patients with COVID-19 in France. J Infect. 2020;81(1):93-94. PMID: 32305489. https://doi.org/10.1016/j.jinf.2020.04.009
Toljan K. Letter to the Editor Regarding the Viewpoint «Evidence of the COVID-19 Virus Targeting the CNS: Tissue Distribution, Host — Virus Interaction, and Proposed Neurotropic Mechanism». ACS Chem Neurosci. 2020;11(8):1192-1194. PMID: 32233443. https://doi.org/10.1021/acschemneuro.0c00174
Li Y, Bai W, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020. PMID: 32104915. https://doi.org/10.1002/jmv.25728
https://doi.org/10.17116/jnevro20201200617 (In Russ.).
Wu Y, Xu X, Chen Z, Duan J, Hashimoto K, Yang L, Liu C, Yang C. Nervous system involvement after infection with COVID-19 and other coronaviruses. Brain Behav Immun. 2020;87:18-22 PMID: 32240762. https://doi.org/10.1016/j.bbi.2020.03.031
Zayratyants O, Samsonova M, Mikhaleva L, Chernyaev A, Mishnev O, Krupnov N, Kalinin D. Pathological anatomy of COVID-19. Atlas. M .: GBU «NIIOZMM DZM», 2020.
Tsygan NV, Odinak MM, Khubulava GG, Tsygan VN, Peleshok AS, Andreev RV, Kurasov ES, Litvinenko IV. Postoperative cerebral dysfunction: the concept of the nosological entity. S.S. Korsakov Journal of Neurology and Psychiatry = Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2017;117(4):34–39 https://doi.org/10.17116/jnevro20171174134-39
Litvinenko IV, Odinak MM, Tsygan NV, Andreev RV, Peleshok AS, Kurasov ES, Yakovleva VA, Ryabtsev AV. Characteristics of postoperative cerebral dysfunction depending on the type and position of the implanted prosthetic heart valve. S.S. Korsakov Journal of Neurology and Psychiatry = Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2019;119(2):18–22 https://doi.org/10.17116/jnevro201911902118

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