Neuropsychiatric Presentation of COVID-19: A Case Report of Disinhibition in an Acute SARS-CoV-2 Infection

HCA Healthc J Med. 2020 Nov 28:1:373-377. doi: 10.36518/2689-0216.1129. eCollection 2020.

Abstract

Description Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) viral infection is notable for a high degree of symptom diversity. Emerging evidence suggests viral invasion of the central nervous system. Therefore, serious neurological and psychiatric manifestations are anticipated. We present the case of a 67-year-old male physician who has a history of stable bipolar disorder for decades and was recently hospitalized for persistent COVID-19 symptoms with documented positive serology. He presented with new and acute onset neuropsychiatric symptoms of disinhibition proximate to the viral infection. We postulate neuroinvasion as the putative origin of the patient's psychiatric instability. Furthermore, an investigation is needed to expand upon our understanding of the potential for neuropsychiatric morbidity related to SARS-CoV-2 for prompt diagnosis and appropriate management. There are also no current studies addressing the risks for neurological and psychiatric symptomatology in SARS-CoV-2 infected patients with persistent chronic mental illness.

Keywords: COVID-19; SARS-CoV-2; bipolar disorder; coronavirus infections; coronavirus infections/complications; disinhibition; neurobehavioral manifestations; neurologic manifestations; neuropsychiatric; virus diseases.

Publication types

  • Case Reports

Grants and funding

This research was supported (in whole or in part) by HCA Healthcare and/or an HCA Healthcare affiliated entity.