SARS-CoV-2-associated first episode of acute mania with psychotic features. (May 2021)

• Record Type: Journal Article
• Authors: Sen, Meltem; Yesilkaya, Umit Haluk; Balcioglu, Yasin Hasan
• Is Part Of: Journal of clinical neuroscience. Volume 87(2021)
• Page Start: 29
• Page End: 31
• Publication Date: 2021-05
• Subjects: Affective psychosis -- Coronavirus pandemic -- COVID-19 -- Neuropsychiatric symptoms -- Psychosis -- SARS-CoV-2 -- Viral encephalitis; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2021.02.012
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Psychoneuroimmunological characteristics of SARS-CoV-2 infection is still obscure. A shortfall exists in demonstrating specific clinical manifestations of the brain involvement of the virus. The presence of cytotoxic edema might be suggestive of the brain involvement of SARS-CoV-2. Neuropsychiatric monitoring should be carefully performed in patients with COVID-19. Abstract: Despite neuropsychiatric outcomes of SARS-CoV-2 infection are now under close scrutiny, psychoneuroimmunological characteristics of COVID-19 and precise pathophysiology of neuropsychiatric manifestations of the infection are still obscure. Moreover, there still exists a shortfall in demonstrating specific clinical manifestations of the brain involvement of the virus. Here, we presented a 33-year-old female patient with COVID-19, reporting acute-onset paranoid delusions symptoms, insomnia and irritability. Cranial MRI showed an hyperintense signal in the splenium of the corpus callosum with decreased apparent diffusion coefficient, which might possibly indicate the presence of cytotoxic edema related to the brain involvement of the infection. Following the completion of SARS-CoV-2 treatment, both cytotoxic edema and psychiatric symptoms resolved. In light of this report, we suggest that either heightened immune response and direct viral infection that SARS-CoV-2 may lead to such psychiatric manifestations and neuropsychiatric monitoring should be performed in patients with COVID-19. Prompt recognition of psychiatric consequences of COVID-19 may help clinicians provide guidance for differential diagnosis and manage them accordingly.