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[Morpheus syndrome: Psychotic symptoms in a case series of patients with COVID-19]
Clément de Crespin de Billy1,2, Cyril Cazals2,3, Pascale Boucher3
1CEMNIS - Noninvasive Neuromodulation Center, University Hospital Strasbourg, 1, place de l'hôpital, 67091 Strasbourg Cedex, France.
Abstract:
During the first wave of the COVID-19 epidemic, the Colmar hospital was at the epicenter of the pandemic in France because of a religious gathering that caused a wave of contamination. In order to face the growing wave of admissions in intensive care, the state in partnership with the army set up the operation MORPHEE aiming at transferring intubated patients to other hospitals. On their return to Alsace, the inter-service liaison psychiatry team was called upon for several of them who presented psychotic disorders on waking up, even though they had no previous psychiatric history, and who had resolved spontaneously. These pictures do not correspond to the delirious pictures usually observed in the ICU, such as "reanimatory black-holes" or "near-death-experience". No iatrogenic origin was found and the imaging examinations do not allow to explain this picture; therefore, we cannot exclude that this picture could be a neurological manifestation of COVID-19. The disorder appeared to be spontaneously resolving, so we would urge caution about a drug approach to this problem.
Insights
COVID-19 patients transferred during Operation MORPHEE developed new-onset psychotic disorders. These symptoms resolved spontaneously, suggesting a potential neurological link to COVID-19 rather than iatrogenic causes.
Area of Science:
- Neurology
- Psychiatry
- Infectious Diseases
Context:
- Colmar hospital was an epicenter of the COVID-19 epidemic in France.
- Operation MORPHEE involved transferring intensive care unit (ICU) patients to manage high admission rates.
Purpose:
- To describe psychotic disorders observed in patients transferred during Operation MORPHEE.
- To investigate the potential causes and characteristics of these novel psychiatric symptoms.
Summary:
- Several patients without prior psychiatric history developed psychotic disorders upon waking after transfer.
- These symptoms differed from typical ICU delirium and near-death experiences.
- No iatrogenic causes were identified, and imaging did not explain the symptoms, suggesting a possible neurological manifestation of COVID-19.
Impact:
- Highlights a potential neurological complication of COVID-19.
- Suggests caution regarding pharmacological interventions for these specific psychotic disorders.
- Underscores the need for further research into the neuropsychiatric effects of COVID-19.
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