Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the neuroendocrine stress axis

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first identified in December 2019, causes coronavirus disease 2019 (COVID-19). It is reasonable to presume that SARS-CoV-2 infection will cause activation of the endocrine stress axis at several levels. The endocrine stress system involves communication among different tissues, including among others, the brain and components of the hypothalamic-pituitary-adrenal (HPA) axis. Dysregulation of the stress system leads to morphologic changes in target organs or epigenetic stem cell changes. These in turn might contribute to the development or exacerbation of various psychiatric disorders. We discuss here the potential impact of an infection such as SARS-CoV-2 on a systemic level and reflect on its potential influence on the endocrine stress axis and the consequent long-term consequences. As SARS-CoV-2 and its host receptor, angiotensin-converting enzyme 2 (ACE2), both impact the HPA axis, we also discuss potential therapeutic strategies.