Neurotropism of SARS-CoV-2: COVID-19 presenting with an acute manic episode.
Identifieur interne : 000530 ( Main/Corpus ); précédent : 000529; suivant : 000531Neurotropism of SARS-CoV-2: COVID-19 presenting with an acute manic episode.
Auteurs : Jamie A. Mawhinney ; Catherine Wilcock ; Hasan Haboubi ; Shahbaz RoshanzamirSource :
- BMJ case reports [ 1757-790X ] ; 2020.
English descriptors
- KwdEn :
- Adult, Affective Symptoms (diagnosis), Affective Symptoms (drug therapy), Affective Symptoms (etiology), Betacoronavirus (isolation & purification), Betacoronavirus (pathogenicity), Cerebrospinal Fluid (virology), Clonazepam (administration & dosage), Coronavirus Infections (cerebrospinal fluid), Coronavirus Infections (diagnosis), Coronavirus Infections (psychology), Coronavirus Infections (therapy), Diagnosis, Differential, Emergency Medical Services (methods), Headache (etiology), Headache (virology), Humans, Male, Neuroimaging (methods), Olanzapine (administration & dosage), Pandemics, Pneumonia, Viral (cerebrospinal fluid), Pneumonia, Viral (diagnosis), Pneumonia, Viral (psychology), Pneumonia, Viral (therapy), Psychiatric Status Rating Scales, Psychomotor Agitation (diagnosis), Psychomotor Agitation (drug therapy), Psychomotor Agitation (etiology), Psychotic Disorders (diagnosis), Psychotropic Drugs (administration & dosage), Treatment Outcome.
- MESH :
- chemical , administration & dosage : Clonazepam, Olanzapine, Psychotropic Drugs.
- cerebrospinal fluid : Coronavirus Infections, Pneumonia, Viral.
- diagnosis : Affective Symptoms, Coronavirus Infections, Pneumonia, Viral, Psychomotor Agitation, Psychotic Disorders.
- drug therapy : Affective Symptoms, Psychomotor Agitation.
- etiology : Affective Symptoms, Headache, Psychomotor Agitation.
- isolation & purification : Betacoronavirus.
- methods : Emergency Medical Services, Neuroimaging.
- pathogenicity : Betacoronavirus.
- psychology : Coronavirus Infections, Pneumonia, Viral.
- therapy : Coronavirus Infections, Pneumonia, Viral.
- virology : Cerebrospinal Fluid, Headache.
- Adult, Diagnosis, Differential, Humans, Male, Pandemics, Psychiatric Status Rating Scales, Treatment Outcome.
Abstract
A 41-year-old man with no significant medical history presented with acute behavioural disruption on the background of a 1-day history of severe headache and a 10-day history of dry cough and fever. He was sexually disinhibited with pressured speech and grandiose ideas. His behaviour worsened, necessitating heavy sedation and transfer to intensive care for mechanical ventilation despite no respiratory indication. Investigations confirmed that he was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neuroimaging and a lumbar puncture were normal. Initial screening for SARS-CoV-2 in the cerebrospinal fluid was negative although no validated assay was available. The patient's mental state remained abnormal following stepdown from intensive care. Psychiatric assessment found features consistent with acute mania, and he was detained under the Mental Health Act. This case indicates the need to consider COVID-19 in a wider series of clinical presentations and to develop a validated assay for SARS-CoV-2 in the cerebrospinal fluid.
DOI: 10.1136/bcr-2020-236123
PubMed: 32540882
PubMed Central: PMC7298665
Links to Exploration step
pubmed:32540882Le document en format XML
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Mawhinney</name><affiliation><nlm:affiliation>Academic Department of Vascular Surgery, King's College London, London, UK jamiemawhinney12@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Wilcock, Catherine" sort="Wilcock, Catherine" uniqKey="Wilcock C" first="Catherine" last="Wilcock">Catherine Wilcock</name><affiliation><nlm:affiliation>Department of Ageing and Health, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Haboubi, Hasan" sort="Haboubi, Hasan" uniqKey="Haboubi H" first="Hasan" last="Haboubi">Hasan Haboubi</name><affiliation><nlm:affiliation>Department of Gastroenterology, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Roshanzamir, Shahbaz" sort="Roshanzamir, Shahbaz" uniqKey="Roshanzamir S" first="Shahbaz" last="Roshanzamir">Shahbaz Roshanzamir</name><affiliation><nlm:affiliation>Department of Ageing and Health, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32540882</idno><idno type="pmid">32540882</idno><idno type="doi">10.1136/bcr-2020-236123</idno><idno type="pmc">PMC7298665</idno><idno type="wicri:Area/Main/Corpus">000530</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000530</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Neurotropism of SARS-CoV-2: COVID-19 presenting with an acute manic episode.</title><author><name sortKey="Mawhinney, Jamie A" sort="Mawhinney, Jamie A" uniqKey="Mawhinney J" first="Jamie A" last="Mawhinney">Jamie A. Mawhinney</name><affiliation><nlm:affiliation>Academic Department of Vascular Surgery, King's College London, London, UK jamiemawhinney12@gmail.com.</nlm:affiliation></affiliation></author><author><name sortKey="Wilcock, Catherine" sort="Wilcock, Catherine" uniqKey="Wilcock C" first="Catherine" last="Wilcock">Catherine Wilcock</name><affiliation><nlm:affiliation>Department of Ageing and Health, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Haboubi, Hasan" sort="Haboubi, Hasan" uniqKey="Haboubi H" first="Hasan" last="Haboubi">Hasan Haboubi</name><affiliation><nlm:affiliation>Department of Gastroenterology, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK.</nlm:affiliation></affiliation></author><author><name sortKey="Roshanzamir, Shahbaz" sort="Roshanzamir, Shahbaz" uniqKey="Roshanzamir S" first="Shahbaz" last="Roshanzamir">Shahbaz Roshanzamir</name><affiliation><nlm:affiliation>Department of Ageing and Health, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK.</nlm:affiliation></affiliation></author></analytic><series><title level="j">BMJ case reports</title><idno type="eISSN">1757-790X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Affective Symptoms (diagnosis)</term><term>Affective Symptoms (drug therapy)</term><term>Affective Symptoms (etiology)</term><term>Betacoronavirus (isolation & purification)</term><term>Betacoronavirus (pathogenicity)</term><term>Cerebrospinal Fluid (virology)</term><term>Clonazepam (administration & dosage)</term><term>Coronavirus Infections (cerebrospinal fluid)</term><term>Coronavirus Infections (diagnosis)</term><term>Coronavirus Infections (psychology)</term><term>Coronavirus Infections (therapy)</term><term>Diagnosis, Differential</term><term>Emergency Medical Services (methods)</term><term>Headache (etiology)</term><term>Headache (virology)</term><term>Humans</term><term>Male</term><term>Neuroimaging (methods)</term><term>Olanzapine (administration & dosage)</term><term>Pandemics</term><term>Pneumonia, Viral (cerebrospinal fluid)</term><term>Pneumonia, Viral (diagnosis)</term><term>Pneumonia, Viral (psychology)</term><term>Pneumonia, Viral (therapy)</term><term>Psychiatric Status Rating Scales</term><term>Psychomotor Agitation (diagnosis)</term><term>Psychomotor Agitation (drug therapy)</term><term>Psychomotor Agitation (etiology)</term><term>Psychotic Disorders (diagnosis)</term><term>Psychotropic Drugs (administration & dosage)</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Clonazepam</term><term>Olanzapine</term><term>Psychotropic Drugs</term></keywords><keywords scheme="MESH" qualifier="cerebrospinal fluid" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Affective Symptoms</term><term>Coronavirus Infections</term><term>Pneumonia, Viral</term><term>Psychomotor Agitation</term><term>Psychotic Disorders</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Affective Symptoms</term><term>Psychomotor Agitation</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Affective Symptoms</term><term>Headache</term><term>Psychomotor Agitation</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Emergency Medical Services</term><term>Neuroimaging</term></keywords><keywords scheme="MESH" qualifier="pathogenicity" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="virology" xml:lang="en"><term>Cerebrospinal Fluid</term><term>Headache</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Diagnosis, Differential</term><term>Humans</term><term>Male</term><term>Pandemics</term><term>Psychiatric Status Rating Scales</term><term>Treatment Outcome</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">A 41-year-old man with no significant medical history presented with acute behavioural disruption on the background of a 1-day history of severe headache and a 10-day history of dry cough and fever. He was sexually disinhibited with pressured speech and grandiose ideas. His behaviour worsened, necessitating heavy sedation and transfer to intensive care for mechanical ventilation despite no respiratory indication. Investigations confirmed that he was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neuroimaging and a lumbar puncture were normal. Initial screening for SARS-CoV-2 in the cerebrospinal fluid was negative although no validated assay was available. The patient's mental state remained abnormal following stepdown from intensive care. Psychiatric assessment found features consistent with acute mania, and he was detained under the Mental Health Act. This case indicates the need to consider COVID-19 in a wider series of clinical presentations and to develop a validated assay for SARS-CoV-2 in the cerebrospinal fluid.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32540882</PMID><DateCompleted><Year>2020</Year><Month>06</Month><Day>23</Day></DateCompleted><DateRevised><Year>2020</Year><Month>06</Month><Day>23</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1757-790X</ISSN><JournalIssue CitedMedium="Internet"><Volume>13</Volume><Issue>6</Issue><PubDate><Year>2020</Year><Month>Jun</Month><Day>14</Day></PubDate></JournalIssue><Title>BMJ case reports</Title><ISOAbbreviation>BMJ Case Rep</ISOAbbreviation></Journal><ArticleTitle>Neurotropism of SARS-CoV-2: COVID-19 presenting with an acute manic episode.</ArticleTitle><ELocationID EIdType="pii" ValidYN="Y">e236123</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1136/bcr-2020-236123</ELocationID><Abstract><AbstractText>A 41-year-old man with no significant medical history presented with acute behavioural disruption on the background of a 1-day history of severe headache and a 10-day history of dry cough and fever. He was sexually disinhibited with pressured speech and grandiose ideas. His behaviour worsened, necessitating heavy sedation and transfer to intensive care for mechanical ventilation despite no respiratory indication. Investigations confirmed that he was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Neuroimaging and a lumbar puncture were normal. Initial screening for SARS-CoV-2 in the cerebrospinal fluid was negative although no validated assay was available. The patient's mental state remained abnormal following stepdown from intensive care. Psychiatric assessment found features consistent with acute mania, and he was detained under the Mental Health Act. This case indicates the need to consider COVID-19 in a wider series of clinical presentations and to develop a validated assay for SARS-CoV-2 in the cerebrospinal fluid.</AbstractText><CopyrightInformation>© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mawhinney</LastName><ForeName>Jamie A</ForeName><Initials>JA</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-7851-7953</Identifier><AffiliationInfo><Affiliation>Academic Department of Vascular Surgery, King's College London, London, UK jamiemawhinney12@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wilcock</LastName><ForeName>Catherine</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Department of Ageing and Health, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Haboubi</LastName><ForeName>Hasan</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Gastroenterology, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Roshanzamir</LastName><ForeName>Shahbaz</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Department of Ageing and Health, Guy's and Saint Thomas' Hospitals NHS Trust, London, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>06</Month><Day>14</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>BMJ Case Rep</MedlineTA><NlmUniqueID>101526291</NlmUniqueID><ISSNLinking>1757-790X</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D011619">Psychotropic Drugs</NameOfSubstance></Chemical><Chemical><RegistryNumber>5PE9FDE8GB</RegistryNumber><NameOfSubstance UI="D002998">Clonazepam</NameOfSubstance></Chemical><Chemical><RegistryNumber>N7U69T4SZR</RegistryNumber><NameOfSubstance UI="D000077152">Olanzapine</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000342" MajorTopicYN="Y">Affective Symptoms</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="Y">isolation & purification</QualifierName><QualifierName UI="Q000472" MajorTopicYN="N">pathogenicity</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002555" MajorTopicYN="N">Cerebrospinal Fluid</DescriptorName><QualifierName UI="Q000821" MajorTopicYN="N">virology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D002998" MajorTopicYN="N">Clonazepam</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="Y">Coronavirus Infections</DescriptorName><QualifierName UI="Q000134" MajorTopicYN="N">cerebrospinal fluid</QualifierName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003937" MajorTopicYN="N">Diagnosis, 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dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="Y">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="Y">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000134" MajorTopicYN="N">cerebrospinal fluid</QualifierName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000523" MajorTopicYN="N">psychology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="N">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011569" MajorTopicYN="N">Psychiatric Status Rating Scales</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011595" MajorTopicYN="Y">Psychomotor Agitation</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="N">diagnosis</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011618" MajorTopicYN="N">Psychotic Disorders</DescriptorName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011619" MajorTopicYN="N">Psychotropic Drugs</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="N">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016896" MajorTopicYN="N">Treatment Outcome</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">infection (neurology)</Keyword><Keyword MajorTopicYN="N">mood disorders (including depression)</Keyword><Keyword MajorTopicYN="N">pneumonia (infectious disease)</Keyword><Keyword MajorTopicYN="N">psychotic disorders (incl schizophrenia)</Keyword></KeywordList><CoiStatement>Competing interests: None declared.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate 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