Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy; CAST - Center for Advanced Studies and Technology, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
Department of Neurosciences, Imaging and Clinical Sciences, "G. d'Annunzio" University of Chieti-Pescara, Chieti, Italy.
Psychiatry Res. 2022 Aug;314:114677. doi: 10.1016/j.psychres.2022.114677. Epub 2022 Jun 9.
Sars-CoV-2 is a respiratory virus that can access the central nervous system, as indicated by the presence of the virus in patients' cerebrospinal fluid and the occurrence of several neurological syndromes during and after COVID-19. Growing evidence indicates that Sars-CoV-2 can also trigger the acute onset of mood disorders or psychotic symptoms. COVID-19-related first episodes of mania, in subjects with no known history of bipolar disorder, have never been systematically analyzed. Thus, the present study assesses a potential link between the two conditions. This systematic review analyzes cases of first appearance of manic episodes associated with COVID-19. Clinical features, pharmacological therapies, and relationships with pre-existing medical conditions are also appraised. Medical records of twenty-three patients fulfilling the current DSM-5 criteria for manic episode were included. Manic episodes started, on average, after 12.71±6.65 days from the infection onset. Psychotic symptoms were frequently reported. 82.61% of patients exhibited delusions, whereas 39.13% of patients presented hallucinations. A large discrepancy in the diagnostic workups was observed. Mania represents an underestimated clinical presentation of COVID-19. Further studies should focus on the pathophysiological substrates of COVID-19-related mania and pursue appropriate and specific diagnostic and therapeutic workups.
Sars-CoV-2 是一种呼吸道病毒，能够进入中枢神经系统，这一点可以从病毒存在于患者的脑脊液中和 COVID-19 期间和之后出现几种神经系统综合征中得到证实。越来越多的证据表明，Sars-CoV-2 还可能引发情绪障碍或精神病症状的急性发作。与 COVID-19 相关的首发躁狂症，在没有已知双相情感障碍病史的患者中从未被系统分析过。因此，本研究评估了这两种情况之间的潜在联系。本系统回顾分析了与 COVID-19 相关的首次出现躁狂发作的病例。还评估了临床特征、药物治疗以及与先前存在的医疗条件的关系。纳入了符合当前 DSM-5 躁狂发作标准的 23 名患者的医疗记录。躁狂发作平均在感染发病后 12.71±6.65 天开始。常报告有精神病症状。82.61%的患者有妄想，而 39.13%的患者有幻觉。观察到诊断工作中的差异很大。躁狂症是 COVID-19 被低估的临床表现。进一步的研究应集中在 COVID-19 相关躁狂症的病理生理基础上，并进行适当和具体的诊断和治疗工作。
