Abstract

Psychotic Disorder Following Recent SARS-CoV-2 (COVID-19) Infection

SARS-CoV-2 (COVID-19) is commonly associated with flu-like symptoms involving fever, cough, fatigue, and shortness of breath; however, COVID-19 has also been linked with a wide variety of sequelae including increased rates of depression, suicidality, and substance use disorders as well as exacerbation of existing psychiatric illnesses. Potential causes may include those directly related to the infection, such as central nervous system inflammation, or indirectly such as increased stress or isolation. In this case report, a previously healthy 39-year-old female patient with no prior psychiatric or family history of mental illness, presents with psychosis a month after a positive COVID-19 Polymerase Chain Reaction (PCR) test. The patient’s family brought the patient to the hospital with reports of uncharacteristic, violent actions and increasingly bizarre behavior. The patient’s medical workup was insignificant, and the patient agreed to a voluntary, psychiatric inpatient stay. Diagnosed with a psychotic disorder due to another medical condition, the patient was stabilized with olanzapine. During the stay in the hospital, the patient was compliant with the medication and gradually showed improvements, being able to effectively stay safe without exhibiting any psychotic behaviors or beliefs. While psycho-social factors may have contributed to the patient’s initial behaviors, organic causes attributable to COVID-19 is suspected to have caused a new onset psychiatric disease, and was successfully managed with low-dose olanzapine. This case highlights the importance of understanding the impact COVID-19 may have on an individual’s neuropsychiatric chemistry and what short-term or long-term effects may result and if it can be prevented.

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