First-Time Psychotic Symptoms in a Patient After COVID-19 Infection—A Case Report

Abstract

A 39-year-old, previously healthy, white male with no personal or family history of mental illness presented with new, first-time psychotic symptoms. The new psychotic symptoms appeared on patient admission to the hospital, occurring during a diagnosis of symptomatic SARS-CoV-2 infection. On the first day of hospitalization for worsening psychotic symptoms and the appearance of aggression toward the staff, the patient was transferred to the psychiatric hospital. After the initial treatment with antipsychotics and benzodiazepines, his mental condition improved. The patient was then transferred for further treatment of his somatic condition in the internal medicine ward, with a recommendation to continue treatment in the psychiatric ward once his somatic condition was stabilized. This is one of the few reported cases of COVID-19-related psychosis in a patient without a personal or family history; moreover, this description contains important data regarding elevated IL-6, which may prove to be a key factor in the induction of new psychotic symptoms. It indicates the important need for careful monitoring of neuropsychiatric symptoms among COVID-19 patients.

The Impact of the COVID-19 Virus Pandemic on the Incidence of First Psychotic Spectrum Disorders

“…The authors must mention the case of a 39-year-old man who developed his first psychotic episode during hospitalization for COVID-19. In the absence of other risk factors, it is hypothesized that it was triggered by a cytokine storm associated with significantly elevated IL-6 levels (more than 10-fold) [ 22 ].…”

Antibodies against SARS-CoV-2 S and N proteins in relapsing-remitting multiple sclerosis patients treated with disease-modifying therapies

“…For this reason, our study determined antibodies against the N and S proteins. Available vaccines against SARS-CoV-2 induce the production of antibodies against the spike (S) protein only [18]. After infection, antibodies to various coronavirus proteins may be synthesised, e.g.…”

COVID-19-Associated Acute Psychotic Disorder—Longitudinal Case Report and Brief Review of Literature

“…Since the early stage of the pandemic, cases describing patients with COVID-19-induced psychosis were increasingly reported in the literature with the aim to highlight one of the numerous possible complications of this rapidly emerging infectious disease. Concerning psychopathological features, numerous cases presented female or male individuals with different types of delusions (i.e., persecutory, grandeur, reference, death, and religious) and auditory hallucinations [ 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 ] as the main part of clinical presentation. Of note, similar to our case, the symptomatology reported in some patients included visual or tactile hallucinations as well [ 28 , 31 , 32 , 33 ], which are a common characteristic of psychosis due to organic aetiology [ 42 ].…”

“…In terms of the timeframe between COVID-19 and the development of psychotic symptoms, various cases showed that psychiatric symptoms appeared during the acute stage of the disease [ 30 , 40 , 41 ], while some cases, including the one reported herein, presented after the resolution of illness [ 27 , 47 , 51 ] or during asymptomatic or mild COVID-19 [ 26 , 32 , 36 , 39 ]. The latter might particularly add to the supporting evidence of either subacute sequelae caused by SARS-CoV-2 neuroinvasion or COVID-19-related stress trigger since there is no evidence of massive systemic inflammation.…”