Emotional Disturbance May Be a Central Nervous System Manifestation of COVID-19

by Linda Kossoff •

What is the burden of depressed mood and anxiety in COVID-19 and its associated disease characteristics?

Bottom line: Given the neuroinvasive potential of coronaviruses, emotional disturbance may be a central nervous system (CNS) manifestation of COVID-19.

BACKGROUND: COVID-19’s manifestations are highly variable and may impact many different organ systems. One element of the virus that may have lasting consequences for affected patients is emotional disturbance, such as depression or anxiety. However, the lasting emotional burden of COVID-19 on patients remains largely uncharacterized.

STUDY DESIGN: Prospective cross-sectional study.

SETTING: Department of Otolaryngology-Head and Neck surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio.

SYNOPSIS: To investigate the burden of depressed mood and anxiety in COVID-19 patients in relation to their symptomology, researchers identified COVID-19-positive patients who received care between March 3 and April 17, 2020. Of the 114 patients who participated, all but two had no previous formal diagnosis of anxiety and/or depression. Participants completed the Patient Health Questionnaire for major depressive disorders and the Generalized Anxiety Disorder questionnaire according to how they felt on the day of enrollment and right after becoming affected by the virus. In addition, participants were asked to rate COVID-19 symptoms such as decreased sense of smell/taste, nasal obstruction, fever, cough, and shortness of breath. Using statistical software, researchers found depressed mood and anxiety to be positively associated with decreased smell and taste, but not fever, cough, or shortness of breath. This finding and the recognition of COVID-19 CNS manifestations that reveal neuroinvasive potential might indicate that emotional disturbance is a CNS manifestation of COVID-19. Study limitations included no shown direct causal link between chemosensory dysfunction and emotional disturbance, and reliance on patient recall.

CITATION: Speth MM, Singer-Cornelius T, Oberle M, et al. Mood, anxiety and olfactory dysfunction in COVID-19: evidence of central nervous system involvement? [published online ahead of print July 2, 2020] Laryngoscope. doi: 10.1002/lary.28964.