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Severe and long‐lasting neuropsychiatric symptoms after mild respiratory symptoms caused by COVID‐19: A case report

BACKGROUND: Coronavirus disease 2019 (COVID‐19) is known to cause not only respiratory but also neuropsychiatric symptoms, which are assumed to be derived from a cytokine storm and its effects on the central nervous systems. Patients with COVID‐19 who develop severe respiratory symptoms are known to...

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Autores principales: Jozuka, Ryosuke, Kimura, Hiroki, Uematsu, Takashi, Fujigaki, Hidetsugu, Yamamoto, Yasuko, Kobayashi, Masato, Kawabata, Kazuya, Koike, Haruki, Inada, Toshiya, Saito, Kuniaki, Katsuno, Masahisa, Ozaki, Norio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8919122/
https://www.ncbi.nlm.nih.gov/pubmed/34889531
http://dx.doi.org/10.1002/npr2.12222
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author Jozuka, Ryosuke
Kimura, Hiroki
Uematsu, Takashi
Fujigaki, Hidetsugu
Yamamoto, Yasuko
Kobayashi, Masato
Kawabata, Kazuya
Koike, Haruki
Inada, Toshiya
Saito, Kuniaki
Katsuno, Masahisa
Ozaki, Norio
author_facet Jozuka, Ryosuke
Kimura, Hiroki
Uematsu, Takashi
Fujigaki, Hidetsugu
Yamamoto, Yasuko
Kobayashi, Masato
Kawabata, Kazuya
Koike, Haruki
Inada, Toshiya
Saito, Kuniaki
Katsuno, Masahisa
Ozaki, Norio
author_sort Jozuka, Ryosuke
collection PubMed
description BACKGROUND: Coronavirus disease 2019 (COVID‐19) is known to cause not only respiratory but also neuropsychiatric symptoms, which are assumed to be derived from a cytokine storm and its effects on the central nervous systems. Patients with COVID‐19 who develop severe respiratory symptoms are known to show severe neuropsychiatric symptoms such as cerebrovascular disease and encephalopathy. However, the detailed clinical courses of patients with neuropsychiatric symptoms caused by mild or asymptomatic COVID‐19 remain poorly understood. Here, we present a case of COVID‐19 who presented with severe and prolonged neuropsychiatric symptoms subsequent to mild respiratory symptoms. CASE PRESENTATION: A 55‐year‐old female with COVID‐19 accompanied by mild respiratory symptoms showed delusion, psychomotor excitement, and poor communication ability during quarantine outside the hospital. Considering her diminished respiratory symptoms, her neuropsychiatric symptoms were initially regarded as psychogenic reactions. However, as she showed progressive disturbance of consciousness accompanied by an abnormal electroencephalogram, she was diagnosed with post‐COVID‐19 encephalopathy. Although her impaired consciousness and elevated cytokine level improved after steroid pulse therapy, several neuropsychiatric symptoms, including a loss of concentration, unsteadiness while walking, and fatigue, remained. CONCLUSIONS: This case suggests the importance of both recognizing that even apparently mild COVID‐19‐related respiratory symptoms can lead to severe and persistent neuropsychiatric symptoms, and elucidating the mechanisms, treatment, and long‐term course of COVID‐19‐related neuropsychiatric symptoms in the future.
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spelling pubmed-89191222022-03-18 Severe and long‐lasting neuropsychiatric symptoms after mild respiratory symptoms caused by COVID‐19: A case report Jozuka, Ryosuke Kimura, Hiroki Uematsu, Takashi Fujigaki, Hidetsugu Yamamoto, Yasuko Kobayashi, Masato Kawabata, Kazuya Koike, Haruki Inada, Toshiya Saito, Kuniaki Katsuno, Masahisa Ozaki, Norio Neuropsychopharmacol Rep Case Reports BACKGROUND: Coronavirus disease 2019 (COVID‐19) is known to cause not only respiratory but also neuropsychiatric symptoms, which are assumed to be derived from a cytokine storm and its effects on the central nervous systems. Patients with COVID‐19 who develop severe respiratory symptoms are known to show severe neuropsychiatric symptoms such as cerebrovascular disease and encephalopathy. However, the detailed clinical courses of patients with neuropsychiatric symptoms caused by mild or asymptomatic COVID‐19 remain poorly understood. Here, we present a case of COVID‐19 who presented with severe and prolonged neuropsychiatric symptoms subsequent to mild respiratory symptoms. CASE PRESENTATION: A 55‐year‐old female with COVID‐19 accompanied by mild respiratory symptoms showed delusion, psychomotor excitement, and poor communication ability during quarantine outside the hospital. Considering her diminished respiratory symptoms, her neuropsychiatric symptoms were initially regarded as psychogenic reactions. However, as she showed progressive disturbance of consciousness accompanied by an abnormal electroencephalogram, she was diagnosed with post‐COVID‐19 encephalopathy. Although her impaired consciousness and elevated cytokine level improved after steroid pulse therapy, several neuropsychiatric symptoms, including a loss of concentration, unsteadiness while walking, and fatigue, remained. CONCLUSIONS: This case suggests the importance of both recognizing that even apparently mild COVID‐19‐related respiratory symptoms can lead to severe and persistent neuropsychiatric symptoms, and elucidating the mechanisms, treatment, and long‐term course of COVID‐19‐related neuropsychiatric symptoms in the future. John Wiley and Sons Inc. 2021-12-10 /pmc/articles/PMC8919122/ /pubmed/34889531 http://dx.doi.org/10.1002/npr2.12222 Text en © 2021 The Authors. Neuropsychopharmacology Reports published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Neuropsychopharmacology. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Case Reports
Jozuka, Ryosuke
Kimura, Hiroki
Uematsu, Takashi
Fujigaki, Hidetsugu
Yamamoto, Yasuko
Kobayashi, Masato
Kawabata, Kazuya
Koike, Haruki
Inada, Toshiya
Saito, Kuniaki
Katsuno, Masahisa
Ozaki, Norio
Severe and long‐lasting neuropsychiatric symptoms after mild respiratory symptoms caused by COVID‐19: A case report
title Severe and long‐lasting neuropsychiatric symptoms after mild respiratory symptoms caused by COVID‐19: A case report
title_full Severe and long‐lasting neuropsychiatric symptoms after mild respiratory symptoms caused by COVID‐19: A case report
title_fullStr Severe and long‐lasting neuropsychiatric symptoms after mild respiratory symptoms caused by COVID‐19: A case report
title_full_unstemmed Severe and long‐lasting neuropsychiatric symptoms after mild respiratory symptoms caused by COVID‐19: A case report
title_short Severe and long‐lasting neuropsychiatric symptoms after mild respiratory symptoms caused by COVID‐19: A case report
title_sort severe and long‐lasting neuropsychiatric symptoms after mild respiratory symptoms caused by covid‐19: a case report
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8919122/
https://www.ncbi.nlm.nih.gov/pubmed/34889531
http://dx.doi.org/10.1002/npr2.12222
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