Neurotropism of SARS-CoV-2: COVID-19 presenting with an acute manic episode.
BMJ Case Rep
; 13(6)2020 Jun 14.
Article
in English
| MEDLINE | ID: covidwho-599775
ABSTRACT
A 41-year-old man with no significant medical history presented with acute behavioural disruption on the background of a 1-day history of severe headache and a 10-day history of dry cough and fever. He was sexually disinhibited with pressured speech and grandiose ideas. His behaviour worsened, necessitating heavy sedation and transfer to intensive care for mechanical ventilation despite no respiratory indication. Investigations confirmed that he was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neuroimaging and a lumbar puncture were normal. Initial screening for SARS-CoV-2 in the cerebrospinal fluid was negative although no validated assay was available. The patient's mental state remained abnormal following stepdown from intensive care. Psychiatric assessment found features consistent with acute mania, and he was detained under the Mental Health Act. This case indicates the need to consider COVID-19 in a wider series of clinical presentations and to develop a validated assay for SARS-CoV-2 in the cerebrospinal fluid.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Psychomotor Agitation
/
Psychotic Disorders
/
Clonazepam
/
Coronavirus Infections
/
Affective Symptoms
/
Pandemics
/
Betacoronavirus
/
Olanzapine
Type of study:
Case report
/
Diagnostic study
/
Prognostic study
/
Qualitative research
Limits:
Adult
/
Humans
/
Male
Language:
English
Year:
2020
Document Type:
Article
Affiliation country:
Bcr-2020-236123
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