Post-COVID-19 Suicide Note: A Case Report of Late Onset Catatonia

ABSTRACT

Coronavirus disease 2019 (COVID-19) creates acute and long-lasting infection which results in respiratory, cardiovascular, and neuropsychiatric problems. Etiology of neuropsychiatric manifestations can be associated with immune system response, inflammatory cytokines, and also the stressors which are experienced by patients as feeling the risk of being infected by the virus, economic problems, and social distancing. We aimed to present a case of a 53-year-old patient whose suicide note was found and was admitted with depressive and catatonic symptoms 8 weeks after the recovery from COVID-19. Catatonia was suspected, and he was given lorazepam 1 mg. Shortly thereafter, he was entirely alert, cooperative, and oriented. As an advantage of this case, the patient in our report had not used medications for COVID-19 and so we could exclude the effect of medications to the pathophysiology of post-coronavirus disease symptoms. A wide spectrum of neuropsychiatric manifestations was observed in terms of diagnosis after COVID-19. Catatonia can break out in the post-infectious period as well as in the para-infectious period. There are limitations to figure out the direct invasion of coronavirus and the effect of the systemic inflammation to the central nervous system. Nevertheless, it should be considered that catatonia may be one of the clinical results of COVID-19.