Can COVID-19 cause psychosis? Doctors explain how it’s possible

You now know the physical symptoms of COVID-19: fever, cough, shortness of breath, new loss of taste or smell – the list goes on. But now, almost a year after the start of the pandemic, doctors are discovering the mental side effects of the new coronavirus.

In addition to neurological complications such as brain fog, dizziness and headaches, doctors are reporting psychosis in a small number of COVID-19 patients who previously had the virus, according to The New York Times. The cases occur in people in their 30s, 40s and 50s, most of whom have no history of mental illness. Here’s what the experts know so far.

What is psychosis and how has it been linked to COVID-19?

Psychosis refers to a mental state in which a person detaches himself from reality; they can no longer distinguish between what is real and what is not. While there is no official research (yet) linking COVID-19 and psychosis, the known case studies are alarming.

A 36-year-old woman tried to get her children through the passage window of a fast food restaurant to prevent them from being kidnapped. A 52-year-old man was convinced he caused the pandemic and attempted suicide out of guilt. A 55-year-old woman hallucinated monkeys and lions, and later convinced herself that a member of her family had been replaced by an impostor.

In the most distressing case, described in The New York Times story, a 42-year-old woman had lingering visions of the murder of her two young children – and had made plans to kill them both.

None of these patients had a history of mental illness, but all had tested positive for COVID-19 or had antibodies. With hospitalization and treatment, all recovered.

How could COVID-19 lead to psychosis?

Doctors initially thought the psychiatric symptoms were the result of long stays in the intensive care unit and high doses of steroids, says Brittany Busse, MD, associate medical director at WorkCare. But that theory changes as more and more evidence emerges. “Many current case studies reveal psychotic symptoms in people with mild illness and no underlying psychiatric condition,” she explains.

Now, doctors are speculating that the psychotic symptoms are the result of inflammation. Specifically, a SARS-CoV-2 infection triggers a “cytokine storm” immune response in some patients, causing potentially fatal inflammation. “It is suspected that this inflammation of the blood vessels also includes inflammation of the brain and nervous system,” says Dr. Busse. This ability to cross the blood-brain barrier could be the cause of symptoms such as loss of smell or taste, brain fog, and even psychosis.

“The current idea is that a number of psychiatric conditions are inflammation of brain cells,” acknowledges Dolores Malaspina, MD, MS, professor of psychiatry and director of the psychosis program at the Icahn School of Medicine at Mount Sinai in New York. York. “COVID is bringing the mind-body connection home, showing that psychiatric disorders are biological as much as physical ones.”

COVID-19 is not the only viral illness that can cause psychosis. Researchers have uncovered reports of post-viral psychosis as far back as the 18th century, and the Spanish flu pandemic of 1918 was the first time it has been documented in significant numbers. In other words, COVID-19 is not unique – a number of diseases have the potential to cause psychosis. (“Viruses were actively under-studied before COVID” when it comes to neurological conditions, says Dr. Malaspina.)

Which patients suffer from post-COVID psychosis?

The New York Times The report notes that most patients with psychosis only had mild symptoms of COVID-19, with some experiencing neurological symptoms such as “tingling of the hands, dizziness, headache or decreased odor.” Two weeks to a few months later, the psychosis set in. Plus, most of the patients are also in their 30s, 40s, and 50s, which is a strange age range. dementia.

At this time, there is no way to tell who, exactly, might be at risk for post-COVID psychosis, says Dr Malaspina. There are simply too few reports and too little research on the emerging neurological impacts of the virus.

“If you or a loved one starts showing signs of not being able to tell the reality from the unreal [including hearing voices, smelling or seeing things that aren’t there, and believing that you are being followed] or if you are having thoughts of suicide or homicide, go to the hospital immediately or call 911, ”advises Dr. Busse. Early action is the key to treatment – and it could protect you and those around you.

The best way to prevent post-COVID psychosis is to simply avoid getting COVID-19 in the first place, says Dr. Busse. Talk to your healthcare professional to see if you are eligible for the vaccine and continue to practice safety measures like washing your hands, wearing a mask, and staying at least six feet away from people who are not in your household. housework.

If you or someone you know is in an emergency, call The National Suicide Prevention Lifeline at 800-273-TALK (8255) or call 911 immediately.

This article is correct at the time of publication. However, as the COVID-19 pandemic rapidly evolves and the scientific community’s understanding of the new coronavirus grows, some information may have changed since the last update. While we seek to keep all of our stories up to date, please visit the online resources provided by the CDC, WHO, and your local public health department to stay informed of the latest news. Always consult your doctor for professional medical advice.

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