LAUSR

To the Editor: Coronavirus disease 2019 (COVID-19) took theworld by surprise. It is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which belongs to the family of coronaviruses. Mental health personnel focus on mitigating psychological morbidities caused by the distress induced by this pandemic. There are psychiatric adversities caused by the virus, immunologic host responses, and some treatment modalities. Following previous coronavirus outbreaks, postviral sequelae were noted, with anxiety, psychoses, and a variety of mood disorders. As a neurotropic virus, SARS-CoV-2 penetrates the central nervous system (CNS) through the olfactory neural pathway. The virus is documented within the CNS and multiplies in neuronal cells in vitro. The in vivo behavior remains unclear. Neuropsychiatric symptoms are reported in patients following COVID-19 infections. These are mental disorders occurring as a consequence of CNS disease/injury. They may be a direct result of viral infestation of the brain or of host immune responses. Coronavirus infections predispose to bipolar or other mood disorders and psychoses. An increased prevalence of antibodies against coronaviruses is documented in psychotic patients. Treatments prescribed for patients with COVID-19 infection, such as corticosteroids and/ or antivirals, may induce psychoses. Hydroxychloroquine can result in adversities of anxiety, mood disorders, insomnia, and/or psychoses. Depression exhibits seasonal variation partly due to alterations in light exposure and/or an increased incidence of viral infections. It is hypothesized that there is a psychoneuroimmunological basis for psychiatric sequelae induced by viral infections. Previous coronavirus epidemics were associated with increased neuropsychiatric manifestations of psychoses, mood disorders, delirium,