长COVID,神经精神疾病,精神药物,现在和未来。

IF 3.8 4区 医学 Q1 Medicine
Acta Neuropsychiatrica Pub Date : 2022-06-01 Epub Date: 2022-03-03 DOI:10.1017/neu.2022.6
Siu Wa Tang, Brian E Leonard, Daiga Maret Helmeste
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引用次数: 27

摘要

“长冠”是指急性发病后持续或出现的症状。自大流行开始(2020-2021年)以来的两年里,主要的长期COVID症状是抑郁、焦虑、疲劳、注意力不集中和认知障碍,很少有精神病的报告。以后是否会出现其他症状尚不清楚。例如,多巴胺依赖型运动障碍通常需要很多年才会出现最初的症状。中风后的抑郁和焦虑可以解释许多早期的长冠状病毒病例。中枢神经系统的出血性、缺氧和炎症损伤、未解决的系统性炎症、代谢障碍、脑血管意外(如中风)、肺损伤引起的缺氧和纤维化改变是长COVID的主要原因。葡萄糖代谢和大脑缺氧问题也可能使患有糖尿病、心血管或肺部疾病的受试者更易患COVID。初步数据表明,精神药物可能没有危险,反而可能有助于对抗COVID-19感染。二甲双胍等治疗糖尿病的药物也是如此。因此,对sigma-1受体配体和葡萄糖代谢的关注有望对新药开发以及现有药物的再利用有所帮助。精神药物和抗组胺药对COVID-19的保护作用的报道,早期关于死后精神分裂症患者大脑中sigma-1受体数量减少的报道,以及许多抗抑郁和抗精神病药物是与sigma-1受体有显著亲和力的抗组胺药,支持sigma和组胺受体在神经炎症和病毒感染中的作用。所有这些领域的文献和数据都在快速积累。我们回顾并讨论了相关的重要文献。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long COVID, neuropsychiatric disorders, psychotropics, present and future.

Long COVID refers to the lingering symptoms which persist or appear after the acute illness. The dominant long COVID symptoms in the two years since the pandemic began (2020-2021) have been depression, anxiety, fatigue, concentration and cognitive impairments with few reports of psychosis. Whether other symptoms will appear later on is not yet known. For example, dopamine-dependent movement disorders generally take many years before first symptoms are seen. Post-stroke depression and anxiety may explain many of the early long COVID cases. Hemorrhagic, hypoxic and inflammatory damages of the central nervous system, unresolved systematic inflammation, metabolic impairment, cerebral vascular accidents such as stroke, hypoxia from pulmonary damages and fibrotic changes are among the major causes of long COVID. Glucose metabolic and hypoxic brain issues likely predispose subjects with pre-existing diabetes, cardiovascular or lung problems to long COVID as well. Preliminary data suggest that psychotropic medications may not be a danger but could instead be beneficial in combating COVID-19 infection. The same is true for diabetes medications such as metformin. Thus, a focus on sigma-1 receptor ligands and glucose metabolism is expected to be useful for new drug development as well as the repurposing of current drugs. The reported protective effects of psychotropics and antihistamines against COVID-19, the earlier reports of reduced number of sigma-1 receptors in post-mortem schizophrenic brains, with many antidepressant and antipsychotic drugs being antihistamines with significant affinity for the sigma-1 receptor, support the role of sigma and histamine receptors in neuroinflammation and viral infections. Literature and data in all these areas are accumulating at a fast rate. We reviewed and discussed the relevant and important literature.

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来源期刊
Acta Neuropsychiatrica
Acta Neuropsychiatrica 医学-精神病学
CiteScore
8.50
自引率
5.30%
发文量
30
审稿时长
6-12 weeks
期刊介绍: Acta Neuropsychiatrica is an international journal focussing on translational neuropsychiatry. It publishes high-quality original research papers and reviews. The Journal''s scope specifically highlights the pathway from discovery to clinical applications, healthcare and global health that can be viewed broadly as the spectrum of work that marks the pathway from discovery to global health.
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