Akinetic Mutism in COVID-19-related encephalopathy: a cytokine-mediated maladaptive sickness behavioral response?

Coronavirus disease 2019 (COVID-19) is a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It primarily causes respiratory symptoms and often presents with flu-like symptoms such as fever, cough, tiredness, and headache. Severe COVID-19 is associated with cytokine storm, an acute systemic hyperinflammatory syndrome defined by elevated circulating cytokine levels and secondary organ dysfunction, including the brain. Herein, we aimed to analyse clinical manifestations of COVID-19-related encephalopathy (CORE) and other cytokine storm-associated encephalopathy (CySE) disorders, with a focus on akinetic-mutism, in a bio-behavioral perspective, suggesting that they may be interpreted as maladaptive sickness behavioral responses caused by cytokine storm.