Studies report that SARS-CoV-2 infected patients experience depression and anxiety ( Yang et al., 2020), which are predecessors or risk factors for suicidality. According to a survey by WHO, more than 93% of countries worldwide demand mental health services ( Chandra et al., 2020 Correa-Palacio et al., 2020). Apart from physical medical consequences, including direct brain damage, mental and social values are also disturbed ( Kaczorowski and Del Grande, 2021). Worldwide, the public is aware of the physical effects of SARS-CoV-2 infection and the preventative steps to take to limit exposure and minimize transmission. The mechanism of long-term neurological manifestations of SARS-CoV-2 is still unclear, and researchers are putting extensive efforts into identifying these pathways. While the direct effects of SARS-CoV-2 on the central nervous system are under detailed investigation ( Desforges et al., 2014 McGavern and Kang, 2011), neurological symptoms like headache, insomnia, impaired cognitive functions, behavioral changes including depression and suicidality, intracranial hemorrhage, and acute cerebral ischemia have been observed in COVID-19 patients ( Mao et al., 2020). The critical disease manifestations of COVID-19 include respiratory symptoms that progress to acute respiratory distress syndrome (ARDS), cardiovascular disorders, multiple organ failure, septic shock, and death ( Baj et al., 2020 Fanelli et al., 2013 Fu et al., 2020). It spread worldwide, leading to severe morbidity and mortality, where more than 4.22 million people have succumbed to the disease as of August 1, 2021( Medicine, J.H.U.o., 2021). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated from Asia. The recurrent waves of the coronavirus disease 2019 (COVID-19) pandemic have affected the lives of billions of people globally. Finally, we touched upon the social determinants of mental health and their impact on disadvantaged populations during times of crisis which may help policymakers set up some action plans to mitigate the COVID-19 mental health turmoil during this ongoing pandemic. Furthermore, we also discuss reasons for vaccine hesitancy and why some groups of people are deprived of vaccines. This review highlights the impact of COVID-19 on the CNS by outlining direct and indirect effects and factors contributing to the decline in people's mental health throughout the COVID-19 pandemic both during and after vaccine administration. Although vaccines have been widely distributed and administered among large populations, vaccine hesitancy still exists and may be due to apprehension about vaccine efficacy, preliminary trials, and associated side effects. Public health emergencies have affected individuals and communities, resulting in emotional reactions and unhealthy behaviors. Work-associated stress, lockdowns, social distancing, and quarantine in response to contain SARS-CoV-2 have also affected the mental health of large populations, regardless of age. Acute neurological symptoms like neuroinflammation, cognitive impairment, loss of smell, and brain stroke are common direct effects among SARS-CoV-2 infected individuals. There is a plethora of evidence for neurological, cognitive, and emotional deficits in COVID-19 patients. The COVID-19 pandemic has persisted for more than a year, and post-COVID-19 sequelae of neurological complications, including direct and indirect effects on the central nervous system (CNS), have been recognized.
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