Psychological Symptoms in COVID-19 Patients: Insights into Pathophysiology and Risk Factors of Long COVID-19

Angel Yun Kuan Thye, Jodi Woan Fei Law, Loh Teng Hern Tan, Priyia Pusparajah, Hooi Leng Ser, Sivakumar Thurairajasingam, Vengadesh Letchumanan, Learn Han Lee

Research output: Journal PublicationReview articlepeer-review

57 Citations (Scopus)


There is growing evidence of studies associating COVID-19 survivors with increased mental health consequences. Mental health implications related to a COVID-19 infection include both acute and long-term consequences. Here we discuss COVID-19-associated psychiatric sequelae, particularly anxiety, depression, and post-traumatic stress disorder (PTSD), drawing parallels to past coronavirus outbreaks. A literature search was completed across three databases, using keywords to search for relevant articles. The cause may directly correlate to the infection through both direct and indirect mechanisms, but the underlying etiology appears more complex and multifactorial, involving environmental, psychological, and biological factors. Although most risk factors and prevalence rates vary across various studies, being of the female gender and having a history of psychiatric disorders seem consistent. Several studies will be presented, demonstrating COVID-19 survivors presenting higher rates of mental health consequences than the general population. The possible mechanisms by which the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the brain, affecting the central nervous system (CNS) and causing these psychiatric sequelae, will be discussed, particularly concerning the SARS-CoV-2 entry via the angiotensin-converting enzyme 2 (ACE-2) receptors and the implications of the immune inflammatory signaling on neuropsychiatric disorders. Some possible therapeutic options will also be considered.

Original languageEnglish
Article number61
Issue number1
Publication statusPublished - Jan 2022
Externally publishedYes


  • ACE-2
  • Anxiety
  • COVID-19
  • Depression
  • Immune inflammatory signaling
  • Mental health
  • Post-traumatic stress disorder (PTSD)
  • SARS-CoV-2

ASJC Scopus subject areas

  • General Biochemistry,Genetics and Molecular Biology
  • General Immunology and Microbiology
  • General Agricultural and Biological Sciences


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