Coronavirus Infection and Mood Disorders: Possible Mechanisms and Pathophysiology

Emerging evidence suggests elevated rates of mood disorders such as agitation, confusion, post-traumatic stress disorder (PTSD), depression and psychosis in the general population during the coronavirus pandemic. In this review, we discussed the etiologic factors and pathophysiology underlying mood disorders development during the COVID-19 pandemic. Based on present evidence, the main pathophysiological mechanisms involved in the association of COVID-19 infection with mood disorders can be considered as the direct effect of coronavirus infection on the brain, and the effect of immune system response induced-inflammation on the brain. Moreover, psychological stresses including social isolation, fear of infection, fear of family members' infection, conflicting messages and instructions about public health measures and economic problems can lead to mood disorders. It seems that virus-immune system interaction-induced or stress-induced inflammation can play the most effective role in the promotion of mood disorders via structural and functional impairments in different areas of the brain, especially in limbic structure. Due to the incidence of mood disorders in the coronavirus pandemic, it seems necessary to pay attention to preventive or therapeutic interventions to management of neuropsychiatric manifestations parallel with therapeutic interventions of other clinical symptoms.