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Date Published: Monday, April 12, 2021
Date Updated: Friday, June 30, 2023

Published Studies Suggest Psychosis is a Symptom of COVID-19 Infection

Symptoms are Result of Brain’s Inflammatory Response to Virus; WMCHealth Seeks Participants in “Long COVID” Cognitive Study

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VALHALLA, NY (April 12, 2021) Paranoia, delusions and other mental health conditions should be considered as potential signs of COVID-19 infection, according to studies authored by behavioral health and emergency medicine specialists at WMCHealth.  The medical journals Psychosomatics and the Journal of Psychiatric Research published the studies, which are part of an international sharing of new findings that point to additional, non-traditional symptoms of the COVID-19 virus and its impact on the brain.

The studies shed new light on the COVID-19 virus' impact on the brain ranging from severe, short-term psychosis to longer-term symptoms that affect memory and cognition. WMCHealth is also recruiting participants for a third study related to cognitive impairment caused by a COVID-19 virus infection.

"COVID-19 psychosis has gotten a lot of attention of late,'' said Stephen Ferrando, MD, Director of Psychiatry at WMCHealth's Behavioral Health Center and the studies' lead author. "It's a phenomenon that is being seen around the world. Patients are being hospitalized with delusions, manic mood disorders and paranoia.  As the virus penetrates the nervous system, we see these symptoms as an inflammatory response in the brain. Even in asymptomatic patients."

WMCHealth staffs its COVID-19 Anxiety and Research Hotline with behavioral health professionals who are available to the public for consultation 24 hours a day, seven days a week at 914.216.7733.  Individuals experiencing acute behavioral health symptoms should be brought immediately to the nearest emergency department for care and evaluation.  

An Inflammatory Response to the Virus

The studies look at different aspects of COVID-19 and mental health. While other studies have attributed mental health problems and substance abuse relapses to isolation and fear that are byproducts of the virus, this research suggests there may be biological reasons for these symptoms, caused by the immune system's inflammatory response to COVID-19 infection. Just as inflammation is responsible for respiratory symptoms such as shortness of breath, the same is true in the brain.

"COVID-19 was initially thought to be a respiratory disease however, with increasing clinical experience worldwide, it is now known to be a multi-system illness impacting the lungs, heart, blood, digestive system, and brain," said Ferrando.

One of the studies summarizes the case of a patient brought to Westchester Medical Center's Emergency Department for delusions and paranoia. The patient had no known history of mental health issues and before admission to the Behavioral Health Center, clinical staff tested the patient for the COVID-19 virus.  The patient's test for active COVID-19 infection was positive, even though the patient exhibited no other symptoms.  The patient's COVID-19 infection symptoms subsided upon treatment for the virus.

Ferrando remarked the COVID-19 infection-related psychosis is usually short-lived, but other brain-related symptoms labeled as neurocognitive dysfunction (or mental "fogginess", as described by those affected) may be long-lived or even permanent.

 "Neuropsychiatric symptoms, including stroke, delirium, psychosis, or a dementia-like syndrome, may occur through direct effects of the virus on the central nervous system," said Ferrando. "This new-onset psychosis associated with COVID-19 infection warrants further investigation."

Call for Study Participants

WMCHealth's Behavioral Health Center seeks a minimum of 200 subjects to participate in a study (Neuropsychiatric Implications of COVID-19 Infection) researching the correlation between COVID-19-related brain inflammation, cognitive impairment and related symptoms.  Mental "fogginess" is a common symptom of "Long COVID", a condition where symptoms of COVID-19 infection linger weeks or even months after diagnosis. WMCHealth's Post-COVID-19 Recovery Program* is currently caring for hundreds of patients with the condition, and WMCHealth behavioral health specialists are collaborating with the program's clinical leaders on the study.

Participation can help lead to better understanding of the condition. Individuals wishing to join the study are welcome to apply and must meet the following inclusion criteria for consideration:

  •  Documented positive COVID-19 test
  • Recovered from the acute illness
  • Completed at least an 8th grade level of education
  • Fluent in the English language
  • Over the age of 20

Potential study subjects are encouraged to call 914.216.7733 ext. 2 or for additional information and appointment scheduling. The hotline is staffed by behavioral health professionals and available to the public 24 hours a day, seven days a week.