COVID-19 and Neurocognitive Disorders

Elizabeta B. Mukaetova-Ladinska; Golo Kronenberg; Ruma Raha-Chowdhury


Curr Opin Psychiatry. 2021;34(2):149-156. 

In This Article


Mild NCD symptoms as a result of the COVID-19 pandemic provide a unique opportunity for researchers to address the early changes that underlie neurocognitive impairment at a clinical and molecular level and to longitudinally follow them with a view to modify their outcomes. From the studies published to date, we know that the biological markers for major NCD of Alzheimer's type develop several decades prior to overt clinical symptoms[63] and it is the convergence of multiple diseases that underpins most clinical dementia syndromes.[64]

The stress related to the COVID-19 pandemic affects similarly the cytokine system and cholinergic pathways, resulting in depression and poor cognitive performance. It is, thus, important to raise awareness for these consequences among the wider population and put into place ways of increasing people's resilience across the lifespan. Identifying biomarkers that may aid in gauging physical and mental resilience will facilitate timely interventions in preparedness for future similar health events.

The properties of SARS-CoV-2 as both a catalyzer and accelerator to brain protein aggregation[65] is another research opportunity for the dementia field in preventing the aggregate prone brain proteins, such as tau protein, β-amyloid and α-synuclein, to form the insoluble and neuronal detrimental deposits. In doing so, we can expect a new generation of therapeutics to be developed, focused on biological mechanisms to prevent and eventually reverse the neurodegenerative processes occurring with ageing and dementia.

The currently ongoing preclinical research to expand the VNS treatment in inflammatory disorders[66] is an overlooked opportunity for the management of both the SARS-CoV-2 infection and the stress-related psychological consequences living with the pandemic. Targeting the α7nAChRs through VNS could hence be another area of interest in the management of COVID-19 related physical (respiratory and gastrointestinal symptoms) and mental health symptoms, including NCD irrespective of its cause and severity.