A Case Report of a Teenager with Acute Psychosis Post-COVID

The coronavirus has been associated with neuropsychiatric sequela. A number of acute psychosis
cases related to Covid were reported recently in adults, and more evidence is suggesting the
virus`s potential of precipitating acute psychosis.
Here we present a case of a 15 years old girl with no prior psychiatric personal history, who
presented with one week of gradual behavioural changes manifested as; disorganized thoughts,
incoherent rapid speech, lack of sleep, deficits in memory, mood swings, and liability.
Two months prior to the outburst of the psychotic symptoms she tested positive for COVID and
experienced mild symptoms though she was vaccinated twice. Three weeks before her admission
with psychosis she was hospitalized due to clinical and laboratory criteria supporting Pediatric
Inflammatory Multisystem Syndrome.Echocardiogram studies indicated no cardiac involvement.
She had improved after treating with steroids and IVIG and was discharged with tapering down
steroid therapy. Later she was admitted for a psychosis workup including blood tests, (MRI),
(MRA), and (EEG), which all were unremarkable. Steroids treatment was halted immediately. She
remained disoriented and experienced insomnia, restlessness, and sadness.
The patient was treated with olanzapine, and gradual improvement was noticed. At discharge,
residual increased speech incoherence still exhibited, and she was released for follow-up and
treatment continuation with olanzapine.
Further investigation and long-term studies on the effect of COVID on mental health in children
should be carried out, also follow-up researches need to be conducted on the psychiatric sequela
and treatment in young patients.