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Can Covid-19 cause viral induced Schizophrenia?

Disasters   (212 Views | 4 Replies)

Myrtle1061RN has 5 years experience as a BSN and specializes in Orthopedics, Pediatrics.

1,146 Profile Views; 22 Posts

The report I received was brief: middle aged, tested positive for Covid-19 last week, sent home to quarantine, no known history of drug abuse or psych issues, but the patient had been found naked in the street and was displaying manic, Schizophrenic behaviors. Oh, and this patient is a nurse. My assignment was to do a 12 hour 1:1 with this patient. I was wearing a surgical gown, a bouffant head cover, goggles, an N-95 and a hand sewn cloth mask to protect my N-95. (Yes, I was blessed to have PPE, but I learned that after a certain point I get claustrophobic; 12 hours is hell.) The Patient was to be NPO, they wanted to get a lumbar puncture and hold any sedating meds until the Psychiatrist sees the patient.

My first impression was that this person was obviously physically exhausted, but I soon learned that the incessant flood of activity in the patient’s brain prevented any rest. The patient would try to focus, try to calm, lay on the bed with closed eyes and then shortly pop back up.

At first the patient seemed oriented, knew where we were, why we were here (Covid) the year, the president, etc., but, then the patient would launch into “You know I’m God, right? And I am the cure!” Religion was a central theme and certain people were named evil, the devil, the Antichrist, etc. If I tried to redirect, the patient quickly became very loud and increasingly more agitated if I did not follow direction. So I spent the day like a puppet, standing here, sitting there, mirroring the patient’s actions- “blink like me, do your arms like this.”

The ordeal was physically, emotionally and mentally challenging, but the biggest question was, WHY? Why would an otherwise, fairly healthy, actively employed nurse split from reality so precipitously?

According to Dr. Google there is a known, but not well studied or understood connection between viral illness and Schizophrenia.

Soooo... now there is that, too...

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46 Posts; 299 Profile Views

did he have any kind of drug screening? just curious, I suspect that self quarantining is going to leave our society with quite a few new cases of addiction to various substances, and not to mention psych issues.

Which leads to my next point: it's not unlikely the guy had some underlying psych issues no one knew about, or that they were triggered by the situation.

So many possibilities, do your docs not have any running theories? Also, is just doing what he says the advised way to handle his disorder? I understand you're trying to keep the situation defused, but in some situations playing along with a patients delusions only encourage and solidify them. He thinks he's god, and you are in fact doing everything he tells you.

Anyway, just thoughts. Good luck, that's a very interesting situation.

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Myrtle1061RN has 5 years experience as a BSN and specializes in Orthopedics, Pediatrics.

22 Posts; 1,146 Profile Views

The room was kind of isolated at the end of the hall, I knew that I was not going to get quick back up if things went bad, so yes, I placated the patient rather than risk escalating to violence. Not my best nursing, but I was afraid for my safety.

Drug abuse is always a possibility, but friends and family vouched for this person that they had never seen any hint of mental illness or drug abuse.

Interestingly, during the 1918 Spanish fLu, a doctor wrote of several cases of Schizophrenia-like illness that he saw in his patients. The patient’s mental health eventually recovered. Hopefully, that is the case with my patient.

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Tegridy specializes in Former NP now Internal medicine PGY-1.

206 Posts; 585 Profile Views

Or he has encephalitis but we don’t have enough history or an lp yet to determine anything. But to answer the question directly. We won’t know for a long time and this doesn’t qualify for schizophrenia anyway since symptoms are <6 months. We may never know the answer to your question though.

Edited by Tegridy

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Myrtle1061RN has 5 years experience as a BSN and specializes in Orthopedics, Pediatrics.

22 Posts; 1,146 Profile Views

Encephalitis is a possibility, but the patient’s vitals were all normal: no fever, no tachycardia, no elevated BP and no signs of nuchal rigidity or even any discomfort.

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