Psychosis in a patient with anti-NMDA-receptor antibodies experiencing significant stress related to COVID-19

Moideen, Shamsudeen; Thomas, Rinu; Kumar, Prawin; Uvais, N A; Katshu, Mohammad Zia Ul Haq

doi:10.1016/j.bbih.2020.100125

Cited by 17 publications

(18 citation statements)

References 7 publications

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“…Monti et al [ 6 ] reported a 50-year-old patient with status epilepticus, anti-NMDAR antibody, and COVID-19 rtPCR positivity but no respiratory or systemic symptoms; Panariello et al [ 4 ] described a 23-year-old boy with acute psychosis due to anti-NMDAR encephalitis, also with no respiratory system involvement. Younger patients with anti-NMDAR encephalitis and COVID-19 positivity were reported by Burr et al [ 5 ] and Moideen et al [ 7 ] in 23 months and 17-year-old patients, respectively, the latter with acute psychosis. Our patient, unlike those in other reports, manifested with acute ataxia, only to become encephalopathic over days.…”

Section: Discussionmentioning

confidence: 76%

“…The pandemic of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has been associated with various neurological complications attributed to neural infection, vascular complications, or the inflammatory reaction. Four adult cases of SARS-CoV-2-associated anti-NMDAR encephalitis and only one young child have been reported to date [ 4 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Pediatric anti-NMDA receptor encephalitis associated with COVID-19

et al. 2021

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Anti-N-methyl-D-aspartate receptor encephalitis is a clinical condition characterized by acute behavioral and mood changes, abnormal movements, autonomic instability, seizures, and encephalopathy. We describe a 7-year-old boy diagnosed with autoimmune encephalitis due to NMDAR antibody in association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019) (COVID-19), without pulmonary involvement or fever. The patient presented with acute ataxia, rapidly developed encephalopathy, and autoimmune encephalitis was suspected. Steroid treatment was withheld because of lymphopenia and intravenous immunoglobulin was started. The absence of clinical response prompted plasmapheresis and, when lymphocyte counts improved, pulse steroid treatment was applied. The latter was followed by significant improvement and the patient was discharged in a conscious and ambulatory state. Autoimmune encephalitis should be considered in the presence of neurological symptoms accompanying SARS-CoV-2 infection and steroid treatment should be preferred unless limited by contraindications.

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Section: Discussionmentioning

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Pediatric anti-NMDA receptor encephalitis associated with COVID-19

et al. 2021

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“…Although the patient is a known drug user which could make it difficult to conclude that his psychosis symptoms are exclusively due to COVID-19, the presence of anti-NMDA antibodies in his CSF analysis confirms the diagnosis of anti-NMDA encephalitis [ 87 ]. Recently, more cases of anti-NMDA encephalitis associated with COVID-19 infection were also reported [ 88 , 89 ].…”

Section: Neurological Complicationsmentioning

confidence: 99%

Acute and Post-Acute Neurological Complications of COVID-19

Al-Ramadan

Rabab’h

Shah

et al. 2021

Neurology International

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Coronavirus disease 2019 (COVID-19) is an emerging global health emergency caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The global outbreak of SARS-CoV-2 infection has been declared a global pandemic by the World Health Organization (WHO). The clinical presentation of SARS-CoV-2 infection depends on the severity of the disease and may range from an asymptomatic infection to a severe and lethal illness. Fever, cough, and shortness of breath are among the most common symptoms associated with SARS-CoV-2 infection. Accumulating evidence indicates that COVID-19 patients commonly develop neurological symptoms, such as headache, altered mental status, anosmia, and myalgia. In this comprehensive literature review, we have summarized the most common neurological complications and reported neurological case studies associated with COVID-19, and neurological side effects associated with COVID-19 treatments. Additionally, the post-acute COVID-19 syndrome and long-term neurological complications were discussed. We also explained the proposed mechanisms that are involved in the pathogenesis of these neurological complications.

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“…Although the majority of the reported psychotic episodes in COVID-19 patients are not supported by detailed laboratory [93] out of a number of antibodies linked to autoimmune encephalitis characterised with neuropsychiatric symptoms [i.e. Anti-Caspr2 (contactin-associated proteinlike 2) antibodies; Anti-AMPA (α-amino-3-hydroxy-5methyl-4-isoxazolepropionic acid) receptor antibodies; Anti-GABA-A (γ-Aminobutyric acid A) receptor encephalitis; Anti-mGluR5 (metabotropic glutamate receptor 5) Dopamine-D2-receptor antibodies and Anti-N-Methyl-d aspartate (NMDA) receptor (anti-NMDAR) antibodies], there is emerging evidence that the NMDAR autoimmune response underlies the autoimmune psychosis in SARS-Cov-2 infection, either directly, as a result of NMDAR encephalitis and the psychosis occurring during symptomatic SARS-COV-2 infection [94,95], or being a stressor precipitating autoimmune disorders, including autoimmune, anti-NMDA receptor psychosis [96].…”

Section: Psychosis and Viral Infectionmentioning

confidence: 99%

Psychological and neuropsychiatric implications of COVID-19

Mukaetova‐Ladinska

Kronenberg

2020

Eur Arch Psychiatry Clin Neurosci

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COVID-19 infections have spread quickly, resulting in massive healthcare burden to societies worldwide. The most urgent interventions needed in the present climate include epidemiological measures to reduce the spread of infection, efficient treatment of patients with severe illness to reduce mortality rates, as well as development of diagnostic tests. Alongside this, the acute, medium, and long-term mental-health consequences of the COVID-19 outbreak for patients, their family members, medical professionals, and the public at large should not be underestimated. Here, we draw on evidence from previous coronavirus outbreaks (i.e., SARS, MERS) and emerging evidence from China, Europe, Asia and the US to synthesize the current knowledge regarding the psychological and neuropsychiatric implications of the COVID-19 pandemic.

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Psychosis in a patient with anti-NMDA-receptor antibodies experiencing significant stress related to COVID-19

Cited by 17 publications

References 7 publications

Pediatric anti-NMDA receptor encephalitis associated with COVID-19

Pediatric anti-NMDA receptor encephalitis associated with COVID-19

Acute and Post-Acute Neurological Complications of COVID-19

Psychological and neuropsychiatric implications of COVID-19

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