Mental health issues and psychiatric illness have become known as some of the possible side-effects of COVID-19 reported by researchers over the last year and a half.
Now, a recently released paper by UCSF on three teenagers suffering from severe and sudden psychiatric symptoms post-COVID-19 might hold some answers as to why.
According to Dr. Sam Pleasure of the UCSF Department of Neurology and of the UCSF Weill Institute, and one of the paper's authors, two of the adolescent patients studied had previously reported mild psychiatric problems – low-level anxiety and depression.
"But after getting COVID-19 and having only mild respiratory symptoms, they developed relatively acute onset of paranoia, delusions that people were out to get them, the police were coming to the house, things like that," Pleasure told KCBS Radio's Holly Quan and Dan Mitchinson on Friday's Ask an Expert.
When they were evaluated in the hospital, including neurological tests, MRIs, and spinal taps to examine their spinal fluid, it was discovered that "there was some degree of inflammation going on."
For at least two of the patients, it became clear to clinicians that this inflammatory response was possibly causing the change in their psychiatric behavior. When treated with immunotherapy, the patients saw improvement in varying degrees.
Clinicians should be aware, and consider that when extreme changes take place in a patient's psychiatric status, it could be related to a recent COVID-19 infection, which could be causing this type of inflammation. That's "the take-home message," said Pleasure.
A key takeaway from the paper is that along with antibodies for COVID-19, researchers found anti-neural antibodies in the patients' cerebrospinal fluid. These "turncoat" antibodies, were attacking the brain instead of foreign contagions.
"This is something that COVID-19 can induce, is a sort of out-of-control inflammation," said Pleasure, in some people, although it's not yet known how common this phenomenon is.
But if someone is dealing with this issue, they would know immediately, he said. "They don't sort of creep up on you, they do start relatively suddenly."
In the teen patients included in the paper, parents reported escalating changes in their children, "overnight, over a few days," said Pleasure.
There have been reports of adults dealing with the same phenomenon as well, although it is still unclear how frequent the issue is.
It's also unclear if these symptoms are related to the symptoms of long COVID-19. "Those studies are ongoing and we should hopefully know at some point, in the not-so-distant future," he said.
