Can Adenovirus Infection Impact Mental Health?

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Adenovirus infections, while usually associated with respiratory illnesses and gastrointestinal disturbances, have garnered increasing attention for their potential impact beyond the realm of physical health. As we delve deeper into the complexities of human biology and the relationship between bodily systems, emerging evidence suggests a possible link between adenovirus infection and mental health outcomes. This article aims to explore this intriguing intersection, probing the question: Can adenovirus infection impact mental health?

What is adenovirus?

Adenovirus refers to a type of virus belonging to a wide range of viruses that typically cause cold or flu-like symptoms. It can also cause conjunctivitis (an eye condition) or gastrointestinal infections. It can affect people any time of the year and can result in severe conditions in those with weak immunity or certain medical conditions.

Symptoms

The symptoms of adenovirus infection depend on the type of virus, and may include the following:

  • Respiratory symptoms: fever, sore throat, runny nose, congestion
  • Conjunctivitis symptoms: red or pink eye, watery eyes, sticky discharge from eyes 
  • Gastrointestinal symptoms: diarrhoea, vomiting, nausea and stomach ache
  • Bladder symptoms: uncommon but could cause inflammation or infection
  • Central nervous system (CNS) symptoms: uncommon but could cause infection of the brain and spinal cord

Severe symptoms of adenovirus could lead to pneumonia (inflammation of the lungs due to an infection) and may require hospitalisation. 

How is adenovirus transmitted?

Transmission of adenovirus from an infected person to others can take place by:1

  • Close physical contact
  • Inhaling contaminated droplets produced by coughing or sneezing
  • Touching your mouth, eyes or nose after touching an object or surface with adenoviruses
  • Contact with an infected person’s stool, for example by changing a baby’s nappy
  • Through water, like swimming pools, but it is not as common

Understanding mental health

Mental health has been more recognised in the last decade and awareness has increased due to alarming rates of depression and suicide globally. Mental health conditions are usually characterised by low mood and behaviour, stress, anxiety, anger, loneliness, or hallucinations.

These feelings and symptoms can negatively affect a person’s daily life and may cause their wellbeing to deteriorate rapidly. There are many types of mental health conditions that can be caused by genetic or environmental factors. These medical conditions are often not obvious in those affected and should be addressed as soon as possible. 

How does adenovirus impact mental health?

According to studies, some viruses (that usually invade tissues other than the brain and nervous system) can penetrate the brain via the bloodstream.2 An example of such a virus is the influenza virus. The virus getting into the brain tissue could cause various symptoms related to mental health such as:2,3

  • Lack of sleep
  • Impaired memory 
  • Aggression
  • Problems with social behaviour and communication 
  • Impaired brain function

Sleep could be affected too, as evidenced by research that studied mice infected with the influenza virus. These mice had hypothermia (low body temperature), lower locomotor activity and less delta-wave amplitude during sleep 24 hours after being introduced to the virus.4 Delta waves are slow waves occurring during the deepest level of sleep, so this indicates that the influenza virus may bring about a less peaceful sleep. 

Insufficient amounts of sleep greatly affect mental and physical health as it causes extreme tiredness over time. However, it is important to note that the results from mice research suggesting sleep disruption may not be directly relevant to what happens in humans. 

Virus infection and mental health conditions

During the 1957 influenza epidemic, it was observed that when people assigned female at birth (AFAB) in Helsinki were exposed to the virus during the second trimester of pregnancy, their children were more likely to be diagnosed with schizophrenia and admitted into a psychiatric facility.

Besides that, bipolar disorder in children may also be caused by people AFAB infected by the influenza virus during their pregnancy. Although plenty of research still needs to be done, the study shows less risk of children having bipolar disorder if their mother did not contract the influenza virus during pregnancy.

Those who have pneumonia due to adenovirus infections may have a higher chance of developing new brain function-related problems. This could be caused by difficulties in doing normal tasks, especially in older patients, such as cooking, walking, or using the bathroom independently. Furthermore, those who had treatment for pneumonia showed a higher risk of depressive symptoms.7

Those with severe pneumonia feel more negatively towards their condition and life, so they may not always comply with their medication and treatment. Thus, anxiety and depression could potentially cause their treatment to decline and their health to get progressively worse.

Indirect impact of other conditions on mental health 

Adenovirus infections could also cause brain-related complications such as febrile seizures, encephalitis (inflamed brain), acute disseminated encephalomyelitis, and aseptic meningitis based on a study conducted on infected children.9 Symptoms of encephalitis include changes in personality or behaviour which some people may never fully recover from. 

The damage to the brain can cause other long-term issues such as problems with attention, concentration, planning and solving problems. Patients may feel helpless and find difficulty in returning back to their normal routine, which not only affects them but also their families or carers. The long-term effects of meningitis may also cause slower body movements related to mental activity, poor planning and poor complex thinking.10 

In addition, an avian adenovirus from India called SMAM-1 is the only animal virus directly linked to human obesity. This could contribute to the worldwide problem of obesity.11 Although this adenovirus does not directly impact patients mentally, obesity has implications which could lead to low self-esteem and body image that could likely affect their mental health.12 

According to Dr. Rana Zabad, a neurologist at Nebraska Medicine, "It is important to note that besides vaccines that are known to decrease the risk of acquiring an infection, there is no specific measure to prevent the progression to a neurological disorder. Additionally, we still don't know why some people will develop neurological issues after contracting a virus, and some don't. But we think that those who do may be genetically predisposed."13 

Future directions and recommendations

Larger studies are needed to gather more evidence of brain complications and psychology affected by adenovirus infections. Although frequently asked, there is currently no direct link between viral infection and human mental illnesses. 

Risk factors for mental health decline in severe complications of adenovirus infection such as encephalitis, meningitis, pneumonia and others should be identified early on. Effective measures and follow-ups with a psychiatrist or therapist should be actively managed to improve the well-being of severely affected patients. 

Summary

In conclusion, there seems to be an indirect link between adenovirus infection and mental health. Adenovirus does not usually cause severe symptoms but when it does lead to complications, it could cause medical conditions like pneumonia or encephalitis which could impact the patient’s mental well-being. The virus could also cause behaviours and symptoms that can affect their psychological thinking such as insufficient sleep, aggression, poor social behaviour and communication, memory loss or impaired brain function.

Two studies showed that adenovirus could cause unborn children to have schizophrenia or bipolar disorder in the future if the mother was infected with the virus at some point during the pregnancy. There is still plenty of evidence to be collected as the studies were small, which hopefully could be done in future research. For now, the current evidence obtained should be utilised to the fullest, and healthcare professionals should direct high-risk patients towards mental health assessments at appropriate facilities. 

References

  1. How Adenovirus Spreads | CDC [Internet]. 2024 [cited 2024 Apr 19]. Available from: https://www.cdc.gov/adenovirus/transmission.html.
  2. Tomonaga K. Virus-induced neurobehavioral disorders: mechanisms and implications. Trends Mol Med [Internet]. 2004 [cited 2024 Apr 19]; 10(2):71–7. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7128097/.
  3. Weed MR, Gold LH. Paradigms for behavioral assessment of viral pathogenesis. In: Advances in Virus Research [Internet]. Academic Press; 2001 [cited 2024 Apr 19]; bk. 56, p. 583–626. Available from: https://www.sciencedirect.com/science/article/pii/S006535270156039X.
  4. Toth LA, Rehg JE, Webster RG. Strain differences in sleep and other pathophysiological sequelae of influenza virus infection in naive and immunized mice. J Neuroimmunol. 1995; 58(1):89–99.
  5. Mednick SA, Machon RA, Huttunen MO, Bonett D. Adult schizophrenia following prenatal exposure to an influenza epidemic. Arch Gen Psychiatry. 1988; 45(2):189–92.
  6. Parboosing R, Bao Y, Shen L, Schaefer CA, Brown AS. Gestational influenza and bipolar disorder in adult offspring. JAMA Psychiatry. 2013; 70(7):677–85.
  7. Pneumonia patients nearly twice as likely to suffer from depression, impairments. ScienceDaily [Internet]. [cited 2024 Apr 19]. Available from: https://www.sciencedaily.com/releases/2013/03/130318132641.htm.
  8. Tai X, Zhou X. Analysis of risk factors for negative emotions in patients with severe pneumonia and their impact on prognosis. J Thorac Dis [Internet]. 2023 [cited 2024 Apr 19]; 15(5):2680–93. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10267902/.
  9. Schwartz KL, Richardson SE, MacGregor D, Mahant S, Raghuram K, Bitnun A. Adenovirus-Associated Central Nervous System Disease in Children. J Pediatr. 2019; 205:130–7.
  10. Damsgaard J, Hjerrild S, Andersen H, Leutscher PDC. Long-term neuropsychiatric consequences of aseptic meningitis in adult patients. Infect Dis (Lond). 2015; 47(6):357–63.
  11. Viruses as an Etiology of Obesity - ProQuest [Internet]. [cited 2024 Apr 19]. Available from: https://www.proquest.com/openview/d725365e859da3dece95b33ea527c02a/1?pq-origsite=gscholar&cbl=48850.
  12. Sarwer DB, Polonsky HM. The Psychosocial Burden of Obesity. Endocrinol Metab Clin North Am [Internet]. 2016 [cited 2024 Apr 19]; 45(3):677–88. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6052856/.
  13. Can viral infections lead to neurological disorders? [Internet]. 2022 [cited 2024 Apr 19]. Available from: https://www.nebraskamed.com/neurological-care/can-viral-infections-lead-to-neurological-disorders.

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This content is purely informational and isn’t medical guidance. It shouldn’t replace professional medical counsel. Always consult your physician regarding treatment risks and benefits. See our editorial standards for more details.

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Tracy Tze Ching Ho

Masters of Pharmacy- MPharm, University of Strathclyde, Scotland

Tracy is a Locum Pharmacist with many years of experience working in the UK specialising in community settings. She has always enjoyed writing health reports during her university days which led her to explore more about science communication. With her knowledge in pharmacy, she believes she can promote better healthcare through her articles and spreading accurate information through research.

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