Psychotic episodes, a rare and oftentimes dangerous side effect of COVID-19, Duke doctor says

Friday, January 29, 2021
DURHAM, N.C. (WTVD) -- In addition to the fatal inflammation that comes with COVID-19, there are other more mysterious effects like the loss of taste and smell. But there's another symptom that's even more unusual.

Brian Kincaid, a Duke University Hospital Psychiatrist was one of the first doctors to witness those symptoms which he called, "Psychosis or severe confusion related to COVID-19."

Kincaid, director of the Psychiatric Emergency Department, told ABC11 that last spring, early in the pandemic, a Triangle-area woman was brought to Duke by emergency medical technicians.

"She was trying to pass her children off to strangers because she believed that people were after them and she was trying to protect them," he said.

The woman tested positive for COVID-19 a few days earlier after she developed mild cold-like symptoms.

She wasn't hospitalized until after the psychotic episodes erupted according to Dr. Kincaid who noted, "There are a number of conditions, a number of substances or medications that can cause psychosis, whether someone has a primary psychotic disorder, such as schizophrenia."

But none of those applied to the woman who is in her 30s according to a report on the case published in BMJ an online medical journal.

Although the woman wants to remain anonymous, she allowed her doctors to talk about her case to raise awareness.

So with no history of mental illness or substance abuse, Kincaid and his colleagues came up with another conclusion.

"We'd settled on the diagnosis of Psychotic Disorder associated with a medical condition. That's sort of the official diagnosis or basically, COVID-19 induced psychosis," he said.

In the published report on the case Kincaid and his colleagues wrote, "To our knowledge, this case represents the first description of symptomatic COVID-19-associated brief psychotic disorder in an individual with no personal or family history of primary psychiatric illness."

Since then, there have been a few dozen more according to Kincaid who added, "It's a temporary condition that is amenable to treatment. And so, this patient was successfully treated with medications."

It is still a mystery as to what exactly causes 'COVID psychosis'.

Kincaid said there are theories it could be caused by inflammatory proteins sent to the brain, or abnormal antibodies, or even a direct attack by the virus on the brain.

Although rare, it can be very dangerous.

"It is important to recognize that confusion can occur, psychosis can occur, and to be on the lookout for any odd behavior," Kincaid said.

The best way to avoid COVID psychosis according to Kincaid is to take the recommended precautions masking, hand washing, and social distancing, and getting vaccinated to avoid getting COVID-19 in the first place.
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