Lithium Toxicity in Two Coronavirus Disease 2019 (COVID-19) Patients

Coronavirus disease 2019 (COVID-19) is a highly contagious disease, which is currently causing a devastating pandemic resulting in more than millions of infected cases worldwide. Emerging evidence reports the impact of several co-morbidities on the clinical features and outcomes of COVID-19. However, the evidence regarding the association of mental health illnesses and psychiatric treatment on the prognoses of COVID-19 is still lacking. Lithium is a commonly prescribed psychiatric medication that is also well known for its highly lethal toxicity. Many factors can fluctuate the level of lithium, such as drug interaction, illness, and infection. Prompt recognition and management of lithium intoxication is required to reduce patients’ morbidity and mortality. Currently, there is no report regarding COVID-19 and lithium toxicity. Herein, we are presenting two patients with COVID-19 who initially presented with signs and symptoms of lithium toxicity. Our cases emphasize the need for special attention in taking care of patients who are taking lithium during the COVID-19 pandemic. In general, we recommend obtaining lithium levels in all patients who have been taking lithium and have the diagnosis of COVID-19.