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Psychiatric symptoms reported worldwide in some COVID-19 patients

A small number of COVID-19 patients are experiencing severe psychiatric symptoms after recovering from the virus.

The New York Times reports that multiple doctors have observed psychiatric symptoms in recovered COVID-19 patients who had no previously recorded history of mental illness.

Studies in the U.K. and Spain have found that a small number of hospitalized coronavirus patients developed “new-onset psychosis,” the Times notes, with similar anecdotal reports coming in from the Midwest.

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The Times did not speak to any patients who had experienced psychiatric symptoms, but some physicians were given permission by their patients to describe their cases.

A 42-year-old mother in New York described continually seeing her children being murdered and said she heard voices telling her to kill her children and herself. In New York City, a 30-year-old man tried to strangle his cousin after becoming convinced they were planning on murdering him. A 49-year-old man described hearing voices and believed himself to be the devil.

The physician treating the 42-year-old mother, Hisam Goueli, told the Times the cases were unique due to the patients’ self-awareness of their mental health decline.

“People with psychosis don’t have an insight that they’ve lost touch with reality,” Goueli said.

Goueli also noted it was unusual that most of these patients were in their 30s and 40s. According to the physician, the symptoms that patients described were more often attributed to schizophrenia in younger people or dementia in the elderly.

Experts have stated that viral effects on the brain may be attributable to the immune system's response or even the physical symptoms that patients experience.

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"Some of the neurotoxins that are reactions to immune activation can go to the brain, through the blood-brain barrier, and can induce this damage,” said Vilma Gabbay, co-director at the Psychiatry Research Institute at Montefiore Einstein (PRIME).

Experts who spoke to the Times concurred with Gabbay's assessment, saying a continued immune response after a patient has recovered could impact the brain, though the symptoms may be dependent on which region of the brain is affected.

Robert Yolken, a neurovirology professor at Johns Hopkins University, told the Times, "Some people have neurological symptoms, some people psychiatric and many people have a combination.”

The Times notes that similar cases were observed in past viruses such as the 1918 Spanish flu, SARS and MERS. Though the mechanism through which these symptoms are brought on is not well understood, experts told the Times that studying these patients could help better understand psychosis.

The duration in which patients suffer from psychiatric symptoms is not certain. One patient described in the Times piece recovered within 40 days while another was reportedly still struggling with psychotic symptoms more than two months after being hospitalized.