COVID-19 and first manic episodes: a systematic review

Area of Science:

• Neurology
• Psychiatry
• Infectious Diseases

Background:

• Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects the central nervous system, leading to neurological syndromes.
• Emerging evidence links SARS-CoV-2 to mood and psychotic disorders.
• First-episode mania in COVID-19 patients without prior bipolar disorder requires systematic analysis.

Purpose of the Study:

• To systematically review and analyze cases of first-episode mania associated with COVID-19.
• To assess the clinical features, treatments, and comorbidities of COVID-19-related mania.
• To investigate the potential link between SARS-CoV-2 infection and the onset of manic episodes.

Main Methods:

• Systematic review of medical records.
• Inclusion of 23 patients meeting DSM-5 criteria for manic episode.
• Analysis of clinical presentation, onset timing, and associated symptoms.

Main Results:

• Manic episodes began approximately 12.7 days after COVID-19 onset.
• Psychotic symptoms were common: 82.61% experienced delusions, 39.13% had hallucinations.
• Significant variability in diagnostic procedures was noted among cases.

Conclusions:

• COVID-19-related mania is an underrecognized clinical manifestation.
• Further research is needed on the pathophysiology of COVID-19-induced mania.
• Specific diagnostic and therapeutic strategies for COVID-19-related mania should be developed.