Tesfaye Elias, Alemayehu Selamawit, Gebru Elias
Jimma University Medical Center, Ethiopia.
St. Paul Hospital Millennium Medical College, Ethiopia.
Case Rep Psychiatry. 2022 Aug 31;2022:8931599. doi: 10.1155/2022/8931599. eCollection 2022.
COVID-19 has been a sudden public health crisis since January 2020, spreading from the city of Wuhan, China, to the whole country within a month and posing serious threats to lives. The pandemic has a profound effect on all aspects of society, including mental health and physical health. The actual effect of the virus on the brain and possible psychiatric manifestations is still an area of study and further investigation. There are also several case reports showing manic like symptoms after COVID-19 infection. We describe the case of a 55-year-old patient who presented with behavioral and mood symptoms after a COVID-19 infection. . The patient presented with behavioral disturbance after a diagnosis of COVID-19. He exhibited symptoms including irritability, verbal and physical aggressiveness, increased goal-directed activity, elated and expansive mood, increased energy, grandiosity and inflated self-esteem, and decreased need for sleep. Findings on psychiatric evaluation encompassing detailed history and mental state examination suggested bipolar disorder due to COVID-19 infections. For this, he was put on sodium valproate 1000 mg per day and later, and he was discharged after 21 days with improvement.
This case highlights the importance of paying attention to psychiatric symptoms in patients with COVID-19 and the early intervention and involvement of psychiatrists especially in critically ill patients. In the present scenario, we urge physicians to pay attention to those cases and be open-minded for such a possible new diagnosis. We also recommend performing antibody tests for CSF and RNA tests for patients with mental abnormalities following COVID-19. Further studies can be performed to identify the relationship between COVID-19 and bipolar disorders.
自2020年1月以来，新型冠状病毒肺炎（COVID-19）一直是一场突发的公共卫生危机，在一个月内从中国武汉市蔓延至全国，对生命构成严重威胁。这场大流行对社会的各个方面都产生了深远影响，包括心理健康和身体健康。病毒对大脑的实际影响以及可能出现的精神症状仍是一个研究和进一步调查的领域。也有几例病例报告显示COVID-19感染后出现躁狂样症状。我们描述了一名55岁患者在COVID-19感染后出现行为和情绪症状的病例。该患者在被诊断为COVID-19后出现行为障碍。他表现出易怒、言语和身体攻击性、目标导向活动增加、情绪高涨和夸大、精力增加、夸大观念和自尊心膨胀以及睡眠需求减少等症状。包括详细病史和精神状态检查在内的精神科评估结果提示为COVID-19感染所致双相情感障碍。为此，给他每天服用1000毫克丙戊酸钠，之后，他在21天后病情好转出院。
本病例强调了关注COVID-19患者精神症状的重要性，以及精神科医生早期干预和参与的重要性，尤其是对重症患者。在当前情况下，我们敦促医生关注这些病例，并对这种可能的新诊断持开放态度。我们还建议对COVID-19后出现精神异常的患者进行脑脊液抗体检测和RNA检测。可以进行进一步的研究以确定COVID-19与双相情感障碍之间的关系。
