A small number of COVID-19 patients experience severe psychiatric symptoms after recovering from the virus.
The New York Times reports that multiple doctors have observed psychiatric symptoms in recovering COVID-19 patients who have no previous history of mental illness.
Studies in the UK and Spain have found that a small number of coronavirus patients admitted to hospital have developed a new psychosis’, says the Times, with similar anecdotal reports coming from the Middle East.
The Times did not speak to patients who had experienced psychiatric symptoms, but some doctors did get permission from their patients to describe their cases.
A 42-year-old mother in New York described seeing her children constantly murdered and said she had heard voices saying she should kill her children and herself. In New York City, a 30-year-old man tried to strangle his cousin after he was convinced they were planning to kill him. A 49-year-old man described hearing voices and believing he was the devil.
The doctor treating the 42-year-old mother, Hisam Goueli, told the Times the cases are unique because of the patient’s self-awareness of their deterioration in mental health.
“People with psychosis have no insight that they have lost touch with reality,” Goueli said.
Goueli also noted that it was unusual for most of these patients to be in their thirties and thirties. According to the physician, the symptoms described by patients are more often attributed to schizophrenia in younger people or dementia in the elderly.
Experts have said that the viral effects on the brain may be due to the immune system’s response or even to the physical symptoms that patients experience.
“Some of the neurotoxins that are responses to immune activation can go to the brain through the blood-brain barrier and can cause this damage,” said Vilma Gabbay, co-director of the Psychiatry Research Institute at Montefiore Einstein (PRIME).
Experts who spoke to the Times agree with Gabbay’s assessment that an ongoing immune response after a patient has recovered can affect the brain, although the symptoms depend on which region of the brain is affected.
Robert Yolken, a professor of neurovirology at Johns Hopkins University, told the Times: “Some people have neurological symptoms, some people are psychiatric, and many people have a combination.”
The Times notes that similar cases have been observed in previous viruses such as the Spanish flu in 1918, SARS and MERS. Although the mechanism by which these symptoms occur is not well understood, experts told the Times that studying these patients may have a better understanding of psychosis.
The length of time patients suffer from psychiatric symptoms is uncertain. One patient described in the Times article recovered within 40 days, while another allegedly still struggled with psychotic symptoms more than two months after being admitted to the hospital.