A small number of COVID-19 patients experience severe psychiatric symptoms after recovery from the virus.
The New York Times reports that multiple physicians have observed psychiatric symptoms in recovered COVID-19 patients who had no previously recorded history of mental illness.
Studies in the UK and Spain have found that a small number of hospitalized coronavirus patients developed “new psychosis,” notes the Times, with similar anecdotal reports from the Midwest.
The Times did not speak to patients who had experienced psychiatric symptoms, but some doctors got their patients’ consent to describe their cases.
A 42-year-old mother in New York described her constantly seeing her children 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 he became convinced they were planning to kill him. A 49-year-old man described hearing voices and believed he was the devil.
The doctor who treated the 42-year-old mother, Hisam Goueli, told the Times that the cases were unique because of the patients’ self-awareness of their deterioration in their mental health.
“People with psychosis have no idea that they have lost touch with reality,” said Goueli.
Goueli also noted that it was unusual for most of these patients to be in their thirties and forties. According to the physician, the symptoms described by patients were more often attributed to schizophrenia in younger people or dementia in the elderly.
Experts have stated that viral effects on the brain can be attributed to the immune system response or even the physical symptoms patients experience.
“Some of the neurotoxins that respond to immune activation can travel to the brain, through the blood-brain barrier, and cause this damage,” said Vilma Gabbay, co-director of the Psychiatry Research Institute at Montefiore Einstein (PRIME).
Experts speaking with the Times agreed with Gabbay’s assessment, saying that a sustained immune response after a patient has recovered could affect the brain, although symptoms may depend on which part 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 seen with previous viruses, such as the 1918 Spanish flu, SARS and MERS. While the mechanism causing these symptoms is not well understood, experts told the Times that studying these patients could help better understand psychosis.
It is uncertain how long patients suffer from psychiatric symptoms. One patient described in the Times piece recovered within 40 days, while another reportedly continued to struggle with psychotic symptoms more than two months after admission to the hospital.