Lovi Nyanyuie Kodjo, Kekrebesi Selase Kofi, Osei Mary, Yeboah Eugene
Department of Internal Medicine, Accra Medical Centre, Accra, Ghana.
Accra Medical Centre, Accra, Ghana.
J Med Case Rep. 2022 Apr 22;16(1):171. doi: 10.1186/s13256-022-03349-z.
The coronavirus disease 2019 syndrome typically consists of respiratory symptoms and other general nonspecific symptoms. Psychotic manifestations of coronavirus disease 2019 attributable to severe acute respiratory syndrome coronavirus 2 infection are seldom reported. We report a case of coronavirus disease 2019 in a young West African male who had no known risk factors of psychiatric illness or past history of psychiatric disease presenting with acute psychosis.
Our patient, who was a young West African male, presented without the typical respiratory symptoms of coronavirus disease 2019 and also without a background history of psychiatric illness or any other significant stressors in his past or present social history. He had acute onset of psychotic symptoms consisting of visual and auditory hallucinations, delusions of persecution, and lack of insight. He was admitted and managed with antipsychotic medication and mood stabilizer. His laboratory workup was normal except for positive coronavirus disease 2019 polymerase chain reaction and his liver enzymes, which showed elevated gamma glutamyl transferase, a finding consistent with coronavirus disease 2019. His head computed tomography scan was also normal. The patient made a gradual recovery from his psychotic symptoms, with gain of insight 7 weeks after onset of symptoms, at which time his coronavirus disease 2019 test came back negative along with other laboratory parameters. He returned to work 12 weeks after his presentation and has been performing well.
Psychosis can be a primary presenting symptom in patients with coronavirus disease 2019, including those without respiratory symptoms.
2019冠状病毒病综合征通常由呼吸道症状和其他一般非特异性症状组成。由严重急性呼吸综合征冠状病毒2感染引起的2019冠状病毒病的精神病性表现鲜有报道。我们报告一例年轻西非男性的2019冠状病毒病病例，该患者无已知精神疾病风险因素或精神疾病既往史，却出现了急性精神病症状。
我们的患者是一名年轻的西非男性，没有2019冠状病毒病的典型呼吸道症状，既往或目前的社会史中也没有精神疾病背景或任何其他重大应激源。他急性起病，出现精神病性症状，包括视幻觉、听幻觉、被害妄想和自知力缺乏。他入院后接受了抗精神病药物和情绪稳定剂治疗。除2019冠状病毒病聚合酶链反应呈阳性以及其肝酶显示γ-谷氨酰转移酶升高外，他的实验室检查均正常，这一结果与2019冠状病毒病相符。他的头部计算机断层扫描也正常。患者的精神病性症状逐渐恢复，症状出现7周后恢复自知力，此时他的2019冠状病毒病检测结果连同其他实验室指标均转为阴性。他在就诊12周后重返工作岗位，目前表现良好。
精神病可能是2019冠状病毒病患者的主要首发症状，包括那些没有呼吸道症状的患者。
