About this Research Topic

Background

Coronavirus disease 2019 (COVID-19), a manifestation of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was declared a pandemic by the World Health Organization (WHO) on March 11, 2020

Many reports have detailed a range of neurological symptoms in SARS-CoV-2 infected patients. In adults, the virus, due to its local or peripheral presence, can lead to systemic inflammatory responses. Moreover, the increase in cytokine levels is associated with even severe neurological dysfunctions. These changes are involved in the pathophysiology of various psychiatric disorders, such as depression, anxiety, post-traumatic stress disorder, and obsessive-compulsive disorder as well as somatic symptoms like body pain, respiratory distress, and neurophysiological alterations such as dysregulation of sleep/wake rhythms and nutrition, presence of fatigue, and increase of inattention and irritability.

Symptoms of COVID-19 can be acute or chronic and persist for a long time. For this reason, the Long Covid or Post-Covid syndrome is now defined as when symptoms persist for more than three months after onset. A systematic review and meta-analysis found persistent symptoms in the adult population. The most frequent were fatigue, headache, attention deficit disorder, hair loss, and dyspnea. Long-term studies in pediatric patients report both neurological problems (headache, fatigue, myalgia, dyspnoea, fatigue, loss of taste or smell); also cognitive (memory, language, attention) and neuropsychiatric such as anxiety, depression, and post-traumatic stress. The persistence of long-term neurological symptoms in both adults and children and adolescents can be explained by hypometabolism-like brain patterns with long COVID-19, involving the medial temporal bilateral lobes, brainstem, cerebellum, and the olfactory gyrus right after correction of the small volume.

However, systematic long-covid results in the pediatric and adolescent populations are still few. Some studies have evidenced greater prevalence of stress symptoms, fear, anxiety, depression and sleep disturbances during COVID-19; these aspects can have an important impact on the quality of life of the patients and it could be related to important neuroendocrinological changes involving hypothalamic-pituitary axis. Adrenocorticotropic hormone and other hypothalamic hormones can be altered and must be evaluated in these patients in order to understand better the pathogenesis.

This Research Topic aims to provide an overview of the effects of Neurobiological implications of Stress brought on by COVID-19 by collecting the most recent research on the psychiatric and neurobiological effects of the COVID-19 pandemic as well as identifying new therapeutic targets and clinical strategies to prevent these effects.
Research areas of interest include, but are not limited to:

• Advances in the field of Stress Neurobiology using translational approaches, integrating basic knowledge and clinical practice. These include the neurological, neuropsychiatric, and neuroendocrinological effects of the COVID-19 infection.
• Studies on the psychological impact of COVID-19 in patients including depression, anxiety, post-traumatic stress disorder, sleep, and attention disorders. This includes the psychological effects of Long Covid.
• Studies on the neurological and psychological effects of COVID-19 in pediatric populations.
• Clinical neuroimaging studies on the neuropsychological and neurological effects of COVID-19 in patients.
• Pet studies on the role of neuroinflammation in Covid-induced psychiatric disorders.
• Long Covid: The role of Pet in identifying the incipient CNS Involvement and subsequent dysfunction associated with COVID-19 infection
• Research on defining and implementing strategies for the treatment of Pandemic stress disorders. Improving fundamental knowledge regarding progression, outcomes, and recovery.


Conflicts of interests: Pasquale Striano has received speaker fees and participated at advisory boards for Biomarin, Zogenyx, GW Pharmaceuticals, and has received research funding by ENECTA BV, GW Pharmaceuticals, Kolfarma srl., and Eisai.

Keywords: COVID-19, sars2, Clinical neuroimaging, inflammation, predisposing factors, Stress, neuropsychiatry, neuroendocrinology, fear, anxiety, depression

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