Prenatal exposure to viral infection and neuropsychiatric disorders in offspring: A review of the literature and recommendations for the COVID-19 pandemic

Abstract

The SARS-CoV-2 virus has emerged as a striking 21st century pandemic. Communities across the globe have experienced significant infection rates and widespread psychosocial stress and trauma, leading to calls for increased allocation of resources for mental health screening and treatment. In addition to the burden of psychosocial stress, there is increasing evidence of direct viral neuroinvasion of the central nervous system through physical contact with the nasal mucosa. In a parallel fashion, there is a significant body of ongoing research related to the risk of in utero viral transmission and the resulting neurodevelopmental impact in the fetus. Aberrant neurodevelopment secondary to viral transmission has previously been related to the later development of psychosis, schizophrenia, and schizophrenia spectrum disorders, generating the hypothesis that this population of individuals exposed to SARS-CoV-2 may see an increased incidence in future decades. We discuss the current understanding of the possible neurotropism and vertical transmission of SARS-CoV-2, and relate this to the history of viral pandemics to better understand the relationship of viral infection, aberrant immune response and neurodevelopment, and the risk for schizophrenia disorder.

Keywords: Infection; Neurodevelopment; Pre-natal exposure; SARS-CoV-2; Schizophrenia risk.

Fig. 1

There is growing evidence to support neurotropism and possible vertical transmission of SARS-CoV-2. Pandemic-associated epidemiological data and maternal immune activation models demonstrate that exposure to viral pathogens and inflammation in utero yields increased risk for neuropsychiatric disorders later in life, such as schizophrenia. Thus, the current pandemic offers a novel opportunity to study the neurodevelopment of schizophrenia, with increased opportunity to study exposure variables, brain morphology, and utilize increased surveillance of symptoms over the course of development.