Hypomanic episode following COVID - 19 Pneumonia - case report

Abstract

Coronavirus disease-2019 (COVID-19), an acute respiratory infection caused by severe acute respiratory distress syndrome-coronavirus-2 (SARS-CoV-2), was declared a pandemic in early 2020. Although the virus primarily affects respiratory and gastrointestinal systems, it is neurotropic and has neuropsychiatric complications. The most common neuropsychiatric manifestations seen in COVID-19 infection include delirium, depression, anxiety and post-traumatic stress disorder; very few cases of mania have been reported. Here, we report two cases –an elderly male and a middle-aged female – without a past history of psychiatric illness, presenting with hypomanic episodes following COVID-19 infection. Their blood investigations were normal, and neuroimaging revealed chronic and age-related changes only. As they showed a good response to mood stabilizer, further evaluation including the CSF study was deferred. Psychiatric symptoms could have been the outcome of an interaction of the psychosocial stressors associated with the pandemic on the brain, which was made vulnerable by the COVID-19 infection.