A small number of patients with COVID-19 experience severe psychiatric symptoms after recovery from the virus.
The New York Times reports that several doctors observed psychiatric symptoms in patients recovering with COVID-19 who had no history of mental illness.
Studies in the UK and Spain have found that a small number of hospitalized coronavirus patients have developed “new-onset psychosis,” the Times notes, with similar anecdotal reports coming from the Midwest.
The Times did not speak to any patients who had psychiatric symptoms, but some doctors received permission from their patients to describe their cases.
A 42-year-old mother in New York continuously described that she saw her children murdered and said that she heard voices telling her to kill her children herself. In New York, a 30-year-old man tried to strangle his cousin after he was convinced that he intended to kill him. A 49-year-old man described hearing the voices and thought he was the devil.
The doctor treating the 42-year-old mother, Hisam Goueli, told the Times that the cases were unique due to patients’ self-awareness of the decline in their mental health.
“People with psychosis have no idea that they have lost touch with reality,” Goueli said.
Goueli also noted that it is unusual for most of these patients to be between 30 and 40 years old. According to the doctor, the symptoms described by patients were more often attributed to schizophrenia in younger people or dementia in the elderly.
Experts say that the viral effects on the brain can be attributed to the response of the immune system or even the physical symptoms that patients experience.
“Some of the neurotoxins that are reactions to immune activation can reach the brain through the blood-brain barrier and induce this damage,” said Vilma Gabbay, co-director of the Montefiore Einstein Institute for Psychiatric Research (PRIME).
Experts who spoke to the Times agreed with Gabbay’s assessment, saying that a continuous immune response after a patient has recovered could affect the brain, although symptoms may depend on the region of the brain affected.
Robert Yolken, a professor of neurovirology at Johns Hopkins University, told the Times: “Some people have neurological symptoms, some psychiatrists and many people have a combination.”
The Times notes that similar cases have been seen in previous viruses, such as the Spanish flu of 1918, SARS and MERS. Although the mechanism by which these symptoms are caused is not well understood, experts told the Times that studying these patients could help better understand psychosis.
The length of time patients suffer from psychiatric symptoms is uncertain. One patient described in the Times recovered within 40 days, while another was still experiencing psychotic symptoms more than two months after admission.