We’re gradually coming to accept that the consequences of Covid will affect substantial numbers of people for a substantial length of time.
It’s not the only respiratory virus that can have serious effects in many areas of the body, including psychiatric ones.
We know Covid invades the brain and nervous system, hence the loss of smell and taste.
Then there’s the so-called cytokine storm causing the severe inflammation everywhere that disturbs brain function through microbleeds and micro-clots in the brain.
Psychiatric symptoms, particularly delirium, were common in previous coronavirus outbreaks of Severe Acute Respiratory disease (SARS) and Middle East Respiratory Syndrome (MERS).
So far, Covid-19 seems to be following a similar pattern.
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Delirium is the most common psychiatric symptom in coronavirus illness in older adults and those with dementia.
It is often a factor in serious illness and is especially prevalent among patients requiring intensive care.
Cognitive and behavioural abnormalities affect a third of those patients after leaving hospital.
When older adults and those with dementia fall very ill they should be screened for delirium and closely monitored in the longer term for cognitive impairment.
Alterations in mental state that aren’t explained by delirium shouldn’t be overlooked and patients with other psychiatric symptoms should be identified and treated.
We have a UK-based group (CoroNerve) which is gathering data through doctor and hospital records of neurological and psychiatric disorders among inpatients with coronavirus.
So far, reports include Covid-19 associated psychosis, mood disorders, and catatonia (not moving) as well as encephalitis and other neurological disorders in hospital patients with the virus.
It’s important to report cases and follow them as we don’t yet know the precise frequency of these conditions and whether they’re also found with milder forms of Covid-19 or if they are only seen in the most severely ill patients.
We now know that people may suffer mental ill health after leaving hospital. High rates of anxiety, depression and post-traumatic stress disorder have been seen in people who recover after a hospital stay for Covid.
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The fact that some patients experience disabling fatigue and brain fog after discharge is now well known.
I’d advise any patient who suffers symptoms after a Covid illness to join a patient support group, not just for the help which will be invaluable, but to add to the knowledge we gain about this post-Covid time.
It’s through patient groups that researchers and organisations such as the WHO Brain Health Unit can collaborate in improving how we manage the acute and long-term mental health of Covid-19 sufferers.
