7 teenagers infected with COVID-19 developed severe mental symptoms

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7 teenagers infected with COVID-19 suddenly developed severe mental symptoms

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7 teenagers infected with COVID-19 suddenly developed severe mental symptoms.  Will the immune response of the COVID-19 increase suicidal tendency? 

Since the outbreak at the end of 2019, the COVID-19 epidemic is still raging around the world, causing a great negative impact on the world economy and society. It is worth noting that the new coronavirus infection can cause many complications and indiscriminate damage to multiple organ systems including the lung, heart, brain, kidney and vascular system.

Therefore, even if some patients recover, the sequelae will seriously affect their lives. However, it is worth noting that some recent studies have found that infection with the COVID-19 will not only affect physical health, but also adversely affect the mental health of patients.

On October 25, 2021, researchers from the University of California, San Francisco published a paper titled Anti-SARS-CoV-2 and Autoantibody Profiles in the Cerebrospinal Fluid of 3 Teenaged Patients With COVID-19 and Subacute Neuropsychiatric Symptoms in JAMA Neurology. research paper.

The study found that three teenagers with mild or asymptomatic COVID-19 had mental symptoms such as suicidal thoughts, “paranoid-like fear”, delusions, and “brain blur”, and the culprit behind it was a possible attack “Traitor” antibodies in brain tissue-anti-neural antibodies, which appear in adolescent patients infected with SARS-CoV-2.

The link between COVID-19 and mental illness

In this study, the research team obtained the patients’ cerebrospinal fluid through a lumbar puncture and found through immunohistochemical staining that the cerebrospinal fluid of patients with mild or asymptomatic COVID-19 contained anti-neural antibodies. This shows that the immune system has undergone uncontrollable changes after being infected with the COVID-19, wrongly targeting the brain instead of the infected virus.

Unlike most psychiatric manifestations, the mental symptoms of the three adolescent COVID-19 patients in the study were sudden onset, progressing rapidly, and significantly changed from their baseline. The patient not only has mild respiratory symptoms, but also obvious neuropsychiatric symptoms, which indicates that infection with the new coronavirus may have short-term and long-term effects on the patient’s mental state.

Clinical and paraclinical characteristics and neuropsychiatric symptoms of three adolescents with COVID-19

In fact, prior to this, a study published by the University of California, San Francisco and Yale University in Cell Reports Medicine on May 18, 2021 also found that there were high levels of cerebrospinal fluid in adult patients with acute COVID-19. With autoantibodies, these patients show obvious neurological symptoms, including intractable headaches, seizures, and loss of smell.

Dr. Samuel Pleasure, the co-corresponding author of this study, said: “It is too early to know whether the new coronavirus is a common cause of neuropsychiatric diseases, but it does seem to be a powerful cause of the development of autoantibodies. At present, it is completely unknown that there is spirit. Disease-prone patients are more likely to experience worsening symptoms after being infected with the COVID-19, or whether COVID-19 can be an independent trigger of mental illness.”

The link between autoantibodies and psychiatric symptoms

After several weeks of hospitalization and continuous psychotropic medication, the two patients received intravenous immunoglobulin therapy, which is an immunomodulatory therapy that suppresses inflammation in autoimmune diseases. Five days later, one of the patients became “more organized, less paranoid, and improved insight”.

It is worth noting that this patient was also found to have autoantibodies against the protein TCF4, which is related to certain schizophrenia. However, it is still unknown whether these antibodies actually interfere with the function of the protein and cause mental illness. Co-corresponding author Dr. Michael Wilson also pointed out that the diagnosis of schizophrenia is based on a series of symptoms, rather than specific biomarkers.

There are autoantibodies against TCF4 in the patient’s cerebrospinal fluid

The second patient appeared to respond moderately to immunotherapy, and her cognition and working memory improved, but continued to experience “impaired emotional and cognitive symptoms” 6 months later. The third patient had no history of mental illness. There was neither SARS-CoV-2 antibody nor anti-neural antibody in the cerebrospinal fluid. He completely recovered through psychotropic drug treatment. His symptoms were ultimately attributed to the use of recreational drugs.

Immunotherapy quickly cures patients with COVID-19 related mental illness

A study published in Biological Psychiatry by researchers from Yale University and the University of California, San Francisco on April 9, 2021 reported a more convincing case.

The study recorded a 30-year-old patient with mild symptoms of COVID-19 who had hallucinations, violent outbreaks, high levels of anxiety and paranoia in the emergency department of a hospital. After antipsychotic treatment failed to achieve lasting remission, he was diagnosed as “autoimmune-mediated psychosis” and received intravenous immunoglobulin therapy. The patient’s symptoms improved significantly after the first day of treatment, and he was eventually discharged from the hospital without taking antipsychotic drugs.

The study’s corresponding author, Dr. Michael Wilson, warned: “Based on such a limited number of patients, we cannot say whether immunotherapy has played any role in the patient’s clinical course. In the case of two patients at the University of California, San Francisco, we cannot Excluding their improvement independent of immunotherapy, this is either due to concurrent treatment with psychotropic medication, or over time.”

immunohistochemistry showing anti-neural antibodies

The researchers said that more studies are necessary to further verify the above findings, but Dr. Samuel Pleasure pointed out that one of the obstacles to expanding this study is the lack of cerebrospinal fluid samples from children. He said: “We don’t often study the cerebrospinal fluid of children. Children with COVID-19 pneumonia need lumbar puncture only in very rare cases, and children with multi-system inflammation usually have no specific reason for lumbar puncture.”

But even if limited by research samples, more and more studies have shown that COVID-19 may increase the risk of a person’s mental and neurological effects. Earlier this year, a study published by a British scholar pointed out that among approximately 250,000 COVID-19 patients over 10 years of age, the diagnosed incidence of neuropsychiatric diseases after 6 months of illness is about 34%, of which 13 % Of people are diagnosed for the first time.

Sum up:

All in all, this study explores the link between COVID-19, anti-neural antibodies, and mental illness. In 3 adolescent patients with COVID-19, the researchers found that immunohistochemical staining of the cerebrospinal fluid of 2 patients showed anti-neural autoantibodies, and the autoantibody targeting TCF4 protein in 1 patient seemed to respond well to immunotherapy.

These findings indicate that COVID-19 may induce mental illness in patients through anti-neural antibodies, such as delusions, brain blur, high anxiety and even suicidal tendencies. This also reminds us that we should pay close attention to the mental state of patients recovering from the COVID-19 and take corresponding measures in time. The war between humans and the COVID-19 virus is not only physical, but also spiritual.

Paper link:
https://jamanetwork.com/journals/jamaneurology/fullarticle/2785032

7 teenagers infected with COVID-19 suddenly developed severe mental symptoms

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