Small number of COVID patients develop severe psychotic symptoms

Physicians in the United States and worldwide are reporting that some patients are developing severe psychotic symptoms weeks after contracting COVID-19. Vilma Gabbay, MD, a co-director of the Psychiatry Research Institute at Montefiore Einstein in the Bronx, says: “Some of the neurotoxins that are reactions to immune activation can go to the brain, through the blood-brain barrier, and can induce this damage.” However, brain scans, spinal fluid analyses, and other tests do not uncover brain infection, notes Gabbay, whose hospital has treated two patients with post-COVID psychosis. One of them is a 49-year-old man who heard voices and believed he was Satan. Hisam Goueli, MD, a physician at South Oaks Hospital in Amityville, NY, says the patients he has treated experienced no respiratory problems, but rather neurological symptoms such as hand tingling, vertigo, headaches, or diminished smell. He adds that most patients are in their 30s, 40s and 50s. Robert Yolken, MD, a neurovirology expert at Johns Hopkins University School of Medicine in Baltimore, says in some cases, patients’ immune systems might be unable to shut down or can remain engaged because of “delayed clearance of a small amount of virus.” Emily Severance, PhD, a schizophrenia expert at Johns Hopkins, says persistent immune activation is a leading explanation for brain fog and memory problems, and may also play a role in cognitive and psychiatric effects.