The first case studies series describing neuropsychiatric manifestations of patients in South Africa, provides evidence of links between psychiatric presentations – from delirium and psychosis to mania – and COVID19. It appears in the SA Medical Journal.
Sandra Fernandes, the head of neuropsychiatry at the University of the Witwatersand, said data on COVID-19-related psychosis were sparse but there was increasing evidence that the virus is capable of invading and living in brain tissue. Fernandes said the series of cases aadded to increasing evidence from around the world that COVID-19 “seems to invade the central nervous system in various ways”.
“Though neuropsychiatric presentations are still evolving, as they become characterised they also seem to vary widely. We cannot definitively say that there is a causal link between COVID-19 infection and psychoses or neuropsychiatric presentations, (but) our cases demonstrate a possible link in the absence of past psychiatric and neurological predispositions to these conditions.”
The complexity of neuropsychiatric manifestations of COVID-19 in South Africa
S Fernandes, N Marques, L Goga.
Published in SA Medical Journal on 29 April 2022
SARS-CoV-2 was first identified in Wuhan City, China, in 2019. Initially it was associated with the development of pulmonary disease, but research over the past 2 years has identified effects on multiple systems. Neuropsychiatric manifestations of COVID-19 have been reported in countries around the world, including new-onset psychosis in patients with no personal or family psychiatric history. We present the first case series describing neuropsychiatric manifestations of patients in Johannesburg, South Africa (SA).
All four patients presented with their index-episode psychosis, and evidence of COVID-19 infection. The patients had varied psychiatric presentations, from delirium and psychosis to mania, and all responded well to low doses of antipsychotics. One patient had newly diagnosed HIV in addition to COVID-19. Further research is needed to determine the prevalence of neuropsychiatric manifestations in acute SARS-CoV-2 infections in SA.
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