The Significant Role of the Sympathetic Nervous System in Hospitalization and Death of Patients With COVID-19: Psycho-Neuroendocrine-Immune Aspect of Stress

Abstract

The primary immune responses to CoV-19 are inter-individual variability against this virus. Studies on the neuro-immune system demonstrate that interactions in these communication pathways can be a reason for several psychiatric disorders and immune-mediated diseases. Stress-related behaviors are significant in the psycho-immune interactions, and even stress-related factors such as socioeconomic status can also play a vital role in these interactions. A literature review on the topic was carried out, and 150 articles were included. Catecholamine and glucocorticoids are stress neurohormones. Noradrenaline as signaling molecules, through macrophages, can be an essential stimulus for cytokine secretion. Glucocorticoids, by both pro-and anti-inflammatory roles in specific conditions, can inhibit the elevation of the inflammatory response by inhibiting the pro-inflammatory macrophage activation and also enhance the anti-inflammatory activity in monocyte/macrophage populations the further eliminate. Stress with this flawed amplification feedback system can disrupt immune homeostasis (cytokine storm) in the patient with COVID-19. This investigation showed that there is a strong link between psycho-neuroendocrine-immune axis organizations against respiratory viral infections during the COVID-19 epidemic. The stress cascade must be responsible for meeting the body's hemostatic challenges in the necessary physiological and metabolic interactions. The motivation of the stress system leads to behavioral/physical variations that are strangely consistent in their qualitative presentation. These variations must be generally adaptive and increase the chances of the individual's survival. In coronavirus respiratory disease, identifying people with acute/chronic psychosocial stress is of particular importance for providing prompt care as soon as possible, as scheduling intervention appears to be an essential factor in reducing stress and hospitalization rate in the intensive care unit (ICU).