Psychotic symptoms in COVID-19 infection: A case series from Lima, Peru

Huarcaya-Victoria, Jeff; Meneses-Saco, Alejandra; Luna-Cuadros, María Alejandra

doi:10.1016/j.psychres.2020.113378

Cited by 20 publications

(26 citation statements)

References 5 publications

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“… Fever None SARS-CoV-2 infection Platelet count 329,000 mm 3 /L Midazolam IV at an outside facility with “little effect,” ziprasidone 40mg (route and frequency not reported) Olanzapine 15mg PO daily Patient had “remission of psychotic symptoms.” Ascertainment – No CSF studies – BFCRS not used Causality – Typical catatonia challenge protocol not used Reporting – Clinical course not described in detail Varatharaj et. al, 2020 18 “One patient with catatonia”, UK Case details not available. Not reported Not reported SARS-CoV-2 infection Not reported Not reported Not reported Reporting – No case details available; high risk of bias Abbreviations: BFCRS = Bush-Francis catatonia rating scale, BID = twice daily, COPD = chronic obstructive pulmonary disease, CRP = C-reactive protein, CSF = cerebrospinal fluid, DM2 = diabetes mellitus, type 2, ECT = electroconvulsive therapy, HD = hospital day, HTN = hypertension, IM = intramuscular, IV = intravenous, LDH = lactate dehydrogenase, Na = sodium, NSTEMI = non-ST elevation myocardial infarction, PO = per mouth, QID = four times daily, SMI = serious mental illness, TIA = transient ischemic attack, TID = three times daily, WBC = white blood cell …”

Section: Discussionmentioning

confidence: 99%

“…Authors have also reported akinetic catatonia in a non-infected Italian patient with no prior psychiatric history, presumably secondary to the psychological stress of lockdown, 17 and a 23-year-old previously healthy Peruvian female who had otherwise asymptomatic SARS-CoV-2 infection that presented with psychosis and akinetic catatonic features in the setting of elevated serum inflammatory markers. 18 …”

Section: Discussionmentioning

confidence: 99%

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COVID-19 and Catatonia: A Case Series and Systematic Review of Existing Literature

Scheiner

Smith

Wohlleber

et al. 2021

Journal of the Academy of Consultation-Liaison Psychiatry

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Background Current observational literature on the mental health impact of the COVID-19 pandemic has focused on anxiety, depression, and sleep-disturbance among the public, healthcare workers, and COVID-19 patients. Case reports suggest catatonia and psychosis may be presenting symptoms of COVID-19 disease with a mechanism postulated to involve central nervous system changes in response to inflammation. There is a lack of robust evidence examining catatonia in this context. We sought to systematically review available case data and contextualize our findings. Case Presentations We present three cases of patients with catatonia seen at a large metropolitan tertiary care hospital in which their catatonia was likely attributable to SARS-CoV-2 infection. Ms. A is a female in her 50s with no psychiatric history who presented with self-inflicted stab wounds following her COVID-19 diagnosis. Ms. B is a female in her 50s with a history of schizophrenia, but no history of catatonia, who presented with akinetic catatonia, SARS-CoV-2 infection, and Clostridium difficile infection, without respiratory manifestations of COVID-19. Ms. C is a female in her 20s with a history of bipolar disorder (type 1) without catatonic features who presented with akinetic catatonia without the physical symptoms of SARS-CoV-2 infection. Discussion We present a brief review of six case reports detailing co-occurring catatonia and SARS-CoV-2 infection and one case report of catatonia attributed to the psychological stress of the COVID-19 pandemic in a patient without SARS-CoV-2 infection. We note one additional case of co-occurring catatonia and SARS-CoV-2 infection for which details are not available. COVID-19-associated catatonia may develop secondary to psychological and physical factors. Cases often report anxiety preceding catatonic symptoms. Developing evidence also suggests SARS-CoV-2 may act directly on the central nervous system or via a systemic inflammatory response. One of our cases featured significant anxiety preceding symptoms, and two had co-occurring elevated serum inflammatory markers. We suggest that clinicians should keep a high index of suspicion for both clinically significant anxiety disorders and catatonia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

COVID-19 and Catatonia: A Case Series and Systematic Review of Existing Literature

Scheiner

Smith

Wohlleber

et al. 2021

Journal of the Academy of Consultation-Liaison Psychiatry

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“…This scale consists of 9 items that evaluated the frequency of depressive symptoms in the previous two weeks, which are rated on a Likert scale ranging from 0 ("not at all") to 3 ("nearly every day"). The PHQ-9 scores re ect 5 categories of severity of depressive disorders: None (0-4), mild (5)(6)(7)(8)(9), moderate (10)(11)(12)(13)(14), moderately severe (15- 19), and severe (20)(21)(22)(23)(24)(25)(26)(27). In studies carried out in Latin America, PHQ-9 has been proven to be a valid and reliable tool for detecting depressive symptoms in various types of populations (17,18).…”

Section: Depressionmentioning

confidence: 99%

“…Previous studies have reported that patients with viral respiratory infections similar to COVID-19 showed varying degrees of mental health problems such as depression, anxiety, adjustment disorder, acute stress-related disorder, and post-traumatic stress disorder (PTSD), even after their recovery from the disease (5). Hence, research in different countries has documented that COVID-19 patients also experienced the onset or exacerbation of diverse problems in their mental health (5)(6)(7). This could be due to diverse factors, from psychosocial problems caused by quarantine and hospitalization (8).…”

Section: Introductionmentioning

confidence: 99%

Mental health in COVID-19 survivors from a general hospital: association with sociodemographic, clinical, and inflammatory variables

Huarcaya-Victoria

Barreto

Aire

et al. 2021

Preprint

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Background: The current COVID-19 (coronavirus disease 2019) pandemic constitutes a significant problem for the world's public health and generates mental health problems.Objective: To describe the characteristics of mental health in survivors of COVID-19 and the main sociodemographic, clinical, and immune factors related.Method: A Cross-sectional and correlational study was conducted on 318 patients (196 women, mean age 54.4 ± 15.1 years) surviving COVID-19 from one hospital in Peru in which sociodemographic, clinical, and immune characteristics were explored. Through telephone interviews, an evaluation of the presence of depressive, anxious, somatic, and distress symptoms was carried out using standardized scales. Adjusted prevalence ratios (PRa) were estimated.Results: A significant proportion of the patients have depressive (30.3%), anxious (29.9%), somatic (33.7%), and distress (28.7%) symptoms. In the regression analysis, the variables associated with a higher frequency of clinically relevant mental symptoms were female sex (depression: aPR = 2.29; anxiety: PRa = 2.71; somatic symptoms: PRa = 2.04; distress: PRa = 2.11), proceeding outside the capital (depression: PRa = 1.61; anxiety: PRa = 1.53), the self-perception of a greater severity of the infection (depression: PRa = 5.53; anxiety: PRa = 2.29; distress: PRa = 14.78), the presence of persistent COVID-19 symptoms (depression: PRa = 8.55; anxiety: PRa = 11.38; somatic symptoms: PRa = 5.46; distress: PRa = 20.55), a history of psychiatric treatment (depression: PRa = 2.29; somatic symptoms: PRa = 2.90 ; distress: PRa = 3.80), the history of a family member infected by COVID-19 (anxiety: PRa = 4.71; somatic symptoms: PRa = 1.99), and a neutrophil-lymphocyte index greater than 6.5 (depression: PRa = 1.67; anxiety: PRa = 1.82).Conclusion: COVID-19 survivors show a high prevalence of negative mental symptoms. Some useful variables have been found when identifying vulnerable patients requiring psychiatric care.

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“…Las presentaciones clínicas más frecuentemente reportadas son delirios estructurados mezclados con características confusionales. Una relación causal entre la infección por SARS-CoV-2 y la aparición de síntomas psicóticos no ha sido establecida, se postula que puede ser resultado de la invasión neuronal, inflamación sistémica, respuesta psicosocial resultante de efectos estresantes de aislamiento prolongado y cambio de la vida durante la pandemia (Huarcaya-Victoria et al, 2020;Parra et al, 2020).…”

Section: Manifestaciones Neurológicasunclassified

Manifestaciones clínicas y complicaciones de la enfermedad por coronavirus 2019 (COVID-19): revisión de la literatura

Briones

Toledo²,

Paiz³

et al. 2020

CTS

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La Enfermedad por Coronavirus 2019 (COVID-19) supone un reto sin precedentes para la salud pública. Los médicos deben fortalecer sus habilidades clínicas para combatir esta nueva enfermedad. El objetivo de esta revisión fue describir los signos, síntomas y complicaciones de pacientes con COVID-19. Se realizó una búsqueda en la literatura en la base de datos PubMed incluyendo publicaciones entre 1 de diciembre 2019 y 15 de agosto 2020, sin restricciones de lenguaje, utilizando las palabras clave ‘COVID-19’ cruzada con ‘manifestaciones clínicas’, ‘signos y síntomas’ y ‘complicaciones’. Se incluyeron revisiones sistemáticas y meta-análisis, estudios epidemiológicos y series de casos. Se identificaron 1,066 artículos, de los cuales se seleccionaron 71 de acuerdo a los contenidos previamente definidos por los autores. La COVID-19 presenta un curso de leve a moderado y severo-crítico, específicamente en mayores de 65 años con o sin comorbilidades. Los signos y síntomas no son específicos y usualmente se superponen de acuerdo a la edad y a la fase de la enfermedad. Los síntomas más comunes son fiebre, tos y fatiga. Síntomas menos comunes incluyen escalofríos, dolor de garganta, cefalea, mialgias/artralgias, pérdida del gusto y del olfato, diarrea, nausea, vómitos, congestión nasal, palpitaciones, opresión precordial y dolor pleurítico. La sintomatología en niños difiere de la de los adultos y el curso es usualmente benigno y de baja mortalidad. La evaluación clínica de COVID-19 supone un reto hoy en día. Sin embargo, el conocimiento de la historia natural de la enfermedad permite situar los síntomas comunes e inespecíficos en el contexto clínico correcto

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Psychotic symptoms in COVID-19 infection: A case series from Lima, Peru

Cited by 20 publications

References 5 publications

COVID-19 and Catatonia: A Case Series and Systematic Review of Existing Literature

COVID-19 and Catatonia: A Case Series and Systematic Review of Existing Literature

Mental health in COVID-19 survivors from a general hospital: association with sociodemographic, clinical, and inflammatory variables

Manifestaciones clínicas y complicaciones de la enfermedad por coronavirus 2019 (COVID-19): revisión de la literatura

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