Importance Neuropsychiatric symptoms have been reported as a prominent feature of postacute sequelae of COVID-19 (PASC), with common symptoms that include cognitive impairment, sleep difficulties, depression, posttraumatic stress, and substance use disorders. A primary challenge of parsing PASC epidemiology and pathophysiology is the lack of a standard definition of the syndrome, and little is known regarding mechanisms of neuropsychiatric PASC. Observations Rates of symptom prevalence vary, but at least 1 PASC neuropsychiatric symptom has been reported in as many as 90% of patients 6 months after COVID-19 hospitalization and in approximately 25% of nonhospitalized adults with COVID-19. Mechanisms of neuropsychiatric sequelae of COVID-19 are still being elucidated. They may include static brain injury accrued during acute COVID-19, neurodegeneration triggered by secondary effects of acute COVID-19, autoimmune mechanisms with chronic inflammation, viral persistence in tissue reservoirs, or reactivation of other latent viruses. Despite rapidly emerging data, many gaps in knowledge persist related to the variable definitions of PASC, lack of standardized phenotyping or biomarkers, variability in virus genotypes, ascertainment biases, and limited accounting for social determinants of health and pandemic-related stressors. Conclusions and Relevance Growing data support a high prevalence of PASC neuropsychiatric symptoms, but the current literature is heterogeneous with variable assessments of critical epidemiological factors. By enrolling large patient samples and conducting state-of-the-art assessments, the Researching COVID to Enhance Recovery (RECOVER), a multicenter research initiative funded by the National Institutes of Health, will help clarify PASC epidemiology, pathophysiology, and mechanisms of injury, as well as identify targets for therapeutic intervention.

中文翻译：

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弥合 COVID-19 神经精神后遗症诊断和管理方面的知识空白。

据报道，神经精神症状是 COVID-19 (PASC) 急性后遗症的一个突出特征，其常见症状包括认知障碍、睡眠困难、抑郁、创伤后压力和物质使用障碍。解析 PASC 流行病学和病理生理学的主要挑战是缺乏对该综合征的标准定义，并且对神经精神 PASC 的机制知之甚少。观察 症状发生率各不相同，但在 COVID-19 住院 6 个月后，多达 90% 的患者和大约 25% 的 COVID-19 未住院成人报告了至少 1 种 PASC 神经精神症状。COVID-19 的神经精神后遗症的机制仍在阐明中。它们可能包括在急性 COVID-19 期间产生的静态脑损伤，由急性 COVID-19 的继发效应、慢性炎症的自身免疫机制、病毒在组织储库中的持续存在或其他潜伏病毒的重新激活引发的神经退行性变。尽管数据迅速涌现，但与 PASC 的可变定义、缺乏标准化的表型或生物标志物、病毒基因型的变异性、确定偏差以及对健康的社会决定因素和大流行相关压力源的解释有限有关的知识差距仍然存在。结论和相关性 越来越多的数据支持 PASC 神经精神症状的高患病率，但目前的文献存在异质性，对关键流行病学因素的评估各不相同。通过招募大量患者样本并进行最先进的评估，研究 COVID 以增强恢复 (RECOVER)，