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First-Onset Psychosis After COVID-19 Infection: A Systematic Review of the Literature
Joan Han1, Theodote K Pontikes2, Jeffrey Zabinski3
1Department of Psychiatry, Johns Hopkins, Baltimore, MD.
Background:
The COVID-19 pandemic has been an inciting factor for a wide variety of neuropsychiatric symptoms, including first-episode psychosis (FEP).
Objective:
The aim of this systematic review was to summarize the current literature on COVID-19 associated postviral FEP.
Methods:
A systematic review was completed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and identified 81 articles that met inclusion criteria.
Results:
Articles included case reports, case series, and cohort studies with postviral FEP occurring outside the setting of delirium, demonstrating a broad range of symptoms.
Conclusions:
This systematic review shows that postviral FEP associated with COVID-19 follows a pattern similar to psychosis associated with other viral infections and is an important consideration when building a differential for FEP when delirium has been ruled out. Better understanding of postviral FEP associated with COVID-19 and other viral illnesses may help clarify aspects of underlying pathophysiology of psychotic symptoms broadly.
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