Mental-health conditions, from substance misuse to depression, have increased during the COVID-19 pandemic. But are there mental health risks to contracting the virus itself?
Research is still ongoing, but there is evidence that COVID-19 infections could be linked to some mental health symptoms. For example, a 2020 study from Wuhan, China, found that about one-third of 214 patients with COVID-19 infection had “neurologic manifestations.” These included symptoms like dizziness and impaired consciousness, or the loss of taste and smell that is now commonly associated with the virus.
Preliminary results of a more recent study, published February 2021, show that COVID-19 survivors may be at higher risk of psychiatric concerns. These included anxiety disorders, insomnia, and dementia. However, further research is needed to confirm these findings.
Even more recently, some clinicians have been warning of another condition associated with COVID-19 and mental health symptoms: encephalitis.
What is encephalitis?
Encephalitis occurs when part of the brain swells or becomes inflamed. Symptoms can vary, depending on what part of the brain is affected. They can include:
Fever
Headache
Neck stiffness
Sensitivity to light or sound
Mental confusion or memory loss
Seizures
Vision changes
Movement disorders
Loss of consciousness
Mood-related symptoms, such as anxiety or irritability
Hallucinations
Excessive sleepiness
To diagnose encephalitis, healthcare providers may conduct scans of the brain, such as an MRI or CT scan. Electroencephalogram (EEG) can reveal the brain’s electrical activity. Patients may also be tested for infection.
Encephalitis is a serious condition that requires fast treatment of the underlying cause, which often includes antivirals or antibiotics. Mild cases often experience a full recovery. More serious cases may require months or even years of treatment and rehabilitation.
How is encephalitis linked to COVID-19?
Encephalitis is usually triggered by an autoimmune response or an infection, such as a virus. Therefore, the COVID-19 virus may cause encephalitis in rare cases.
A recent review of 23 studies looked at the outcomes of patients who developed encephalitis as a complication of COVID-19. Among hospitalized patients, the incidence of encephalitis was only 0.215 percent, and more likely in severely ill patients. For those few patients, the mortality rate was a significant 13.4 percent.
Paula Carvalho, MD, of the University of Idaho, has reported on a specific case of encephalitis in a 36-year-old man who was previously healthy, with no history of a psychiatric condition or drug use. He contracted a mild case of COVID-19. Two days after his symptoms resolved, however, he became physically and verbally aggressive.
When his family brought him to the ER, his vital signs were normal, and he showed no signs of infection, except testing positive for COVID-19. Brain MRI results indicated encephalitis. After treatment, the patient improved, and his mental status gradually returned to normal until he was discharged to home in 18 days.
The bottom line: Clinicians should be aware of this risk, and suggest the possibility of COVID-19 encephalitis for clients who exhibit abnormal behavior, acute psychosis, a confused state, or drowsiness.
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