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Dec. 30, 2020 -- Doctors who treat COVID-19 patients are reporting that a small number of them are developing severe psychotic symptoms weeks or months after contracting the virus, the New York Timesreported.

Most of those patients had mild physical symptoms from coronavirus and usually had no history of mental illness, the Times said.

One patient described by the Times was 42 years old, a physical therapist and the mother of four children, aged 2-10. She got the coronavirus in the spring, had mild symptoms, and months later heard a voice telling her to kill herself and then telling her to kill her children.

She took herself to a psychiatric hospital in Amityville, NY.

“It was like she was experiencing a movie, like 'Kill Bill,'” a psychiatrist at the hospital, Hisam Goueli, MD, told the Times.

“It's a horrifying thing that here's this well-accomplished woman and she's like, 'I love my kids, and I don't know why I feel this way that I want to decapitate them,'” he said.

Goueli said he didn't know at first if the reaction was COVID-related, but cases of other patients who had COVID-19 and were reporting psychotic reactions came in over the following weeks.

Another case cited by the Times was a North Carolina woman who believed her children were going to be kidnapped. In an effort to save them, she tried to pass them through a fast food restaurant's drive-thru window.

It's unclear how often this problem appears in COVID-19 patients. The Times mentioned that a British study of neurological or psychiatric complications in 153 hospitalized COVID-19 patients found that 10 people had “new-onset psychosis.”

“My guess is any place that is seeing COVID is probably seeing this,” Colin Smith, MD, of Duke University Medical Center in Durham, N.C., told the Times.

As the pandemic has progressed, doctors have noticed that the coronavirus can cause problems outside the respiratory system.

A study published in November in the Lancet, a British medical journal, found that about 20% of coronavirus survivors developed a new mental illness such as anxiety or depression within 90 days of being diagnosed with coronavirus. Of those diagnosed with mental illness, only 6% had a first-time diagnosis. Researchers also found higher risks for developing dementia in patients over age 65.

In the Times story, most of the people reporting psychotic reactions had no history of mental illness and were in their 30s, 40s and 50s, the doctors said. Typically, psychosis is found in younger or older people.

More experts are coming to believe that brain-related effects may be connected to the body's immune system response to COVID-19 and possibly to vascular problems or surges of inflammation, the Times said.

Some of the patients needed weeks to recover. The physical therapist who wanted to kill her children was hospitalized for about 4 weeks and was given several different medications before the antipsychotic risperidone started working.

“We don't know what the natural course of this is,” Goueli said. “Does this eventually go away? Do people get better? How long does that normally take? And are you then more prone to have other psychiatric issues as a result? There are just so many unanswered questions.”

 

Show Sources

The New York Times. “Small Number of Covid Patients Develop Severe Psychotic Symptoms”

National Institutes of Health. "Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study"

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