Psychotic decompensation in the course of SARS-COV-2 infection - case report

Abstract

Introduction: SARS-CoV-2 is a single-stranded RNA virus belonging to the group of coronaviruses. Among patients infected with the COVID virus, neuropsychiatric symptoms are observed, such as dizziness and headaches, anxiety, depression, as well as delusions and hallucinations. Psychotic symptoms have been observed in patients infected with SARS-CoV-2 without a prior psychiatric history. Aim: The purpose of this study was to present a case of a patient with neuropsychiatric symptoms, most likely caused by a past COVID infection, and to present possible pathophysiological mechanisms explaining neuropsychiatric symptoms in the course of SARS-CoV-2 infection. Material and methods: Literature review was carried out using electronic databases: PubMed, Google Scholar, using the following keywords: SARS-COV-2, neuropsychiatric symptoms, reactive psychosis, cytokine storm, limiting the search scope to 2019-2023. Publications in English were used. The patient's medical records, results of laboratory and imaging tests and descriptions of psychological tests were used to describe the case. Case description: A 27-year-old patient, not previously treated psychiatrically, with a recent COVID-19 infection, who developed acute, quickly passing psychotic symptoms in the form of persecutory delusions and visual and auditory hallucinations in a short period of time. Discussion: The effect of the SARS-CoV-2 virus on the central nervous system is not fully understood - the literature presents several possible mechanisms underlying the neuropsychiatric manifestations of SARS-CoV-19 infection, which include viral infiltration into the central nervous system, dysregulation of the cytokine network and excitotoxicity and translocation of intestinal microbes. Keywords: SARS-COV-2, neuropsychiatric symptoms, reactive psychosis, cytokine storm