From the beginning of the COVID-19 outbreak, clinicians have known that the virus can cause acute respiratory distress. Anew study suggests it may have neuropsychiatric effects as well.
That is according to a team of British scientists, who recently published a paper on neuropsychiatric complications stemming from COVID-19. In an online edition of The Lancet, the researchers reported an array of symptoms, from strokes to altered mental states like new-onset psychosis.1 Surprisingly, they discovered “that acute alterations in mental status were disproportionately overrepresented in younger patients.”
Up until now, published reports on COVID-19’s neuropsychiatric effects have been largely anecdotal, limited to individual cases or a small case series. The British study is the first nationwide survey, which was based on 153 cases submitted by clinicians across the United Kingdom. It was undertaken to explore the proportion of neurological and psychiatric complications that affect the central nervous system versus the peripheral nervous system, as well as who was most at risk for these symptoms.
The researchers found a number of psychiatric complications. “Altered mental status was the second most common presentation,” they wrote. Of patients with complete datasets, 31% received a psychiatric diagnosis. Clinicians reported 4 cases of affective disorders, 6 cases of dementia-like symptoms, and 10 cases of new-onset psychosis. There was also 1 case of catatonia and another of mania. Only 2 patients had “exacerbations of existing enduring mental illness.”
According to the report’s authors, altered mental states are common in cases of severe infection, but “this symptom typically predominates in older groups.”The COVID-19 data told a different story. Almost half of the patients with psychiatric complications from COVID-19 were 59 years or younger.
The authors offered at least 1 possible explanation. “The large number of patients with altered mental status might reflect increased access to neuropsychiatry or psychiatry review for young patients,” they wrote. But the exact relationship between COVID-19 and mental health remains a mystery, especially where younger individuals are concerned. The authors insist that “confirmation of the link between COVID-19 and new acute psychiatric or neuropsychiatric complications in younger patients will require detailed prospective longitudinal studies.”
Although further study may be necessary to draw firm conclusions, one thing is certain: “Severe neurological and neuropsychiatric presentations associated with COVID-19 have become increasingly apparent.”
1. Varatharaj A, Thomas N, Ellul MA, et al. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study [published online ahead of print, 2020 Jun 25] [published correction appears in Lancet Psychiatry. 2020 Jul 14;:]. Lancet Psychiatry. 2020; S2215-0366(20)30287-X.