Refractoy psychosis after mRNA COVID-19 vaccine
DOI:
https://doi.org/10.25118/2763-9037.2023.v13.432Keywords:
Sars-Cov-2, psychosis, vaccination, COVID-19Abstract
Introduction: The vaccination against SARS-CoV-2 has shown efficacy in decreasing morbidity and mortality. There are several systemic side effects and some neuropsychiatric manifestations described. Case report: A 38-year-old woman was admitted to the Psychiatry of the Conjunto Hospitalar de Sorocaba presenting disorganized behavior and aggressiveness. Six months ago, she received the first dose of the mRNA vaccine for COVID-19 and, around 24 hours later, had systemic adverse effects followed by aggressiveness and delusional thinking of persecutory nature. She had no past clinical or psychiatric reports. Previously, she was perfectly functional. We performed an extensive clinical-laboratorial investigation, and all tests were negatives. Several pharmacological therapies with antipsychotics and mood stabilizers were used, but after more than four months of hospitalization, the improvements observed were just in orientation and behavior, remaining with symptoms of psychosis. Discussion: This is the first report of refractory psychosis after COVID-19 immunization with no improvement of symptoms; there have been related psychoses after COVID-19 immunization. It is suggested that the psychosis occurs by the intense cytokine storm, leading to a high pro-inflammatory status. It is hypothesized that vaccination causes a strong immune response against the SARS-CoV-19; therefore, similarly mechanisms could underlie the psychosis after COVID-19 immunization.
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Mathieu E, Ritchie H, Rodés-Guirao L, Appel C, Gavrilov D, Giattino C, Hasell J, Macdonald B, Dattani S, Beltekian D, Ortiz-Ospina E, Roser M. Coronavirus pandemic (COVID-19). [Oxford]: Our World In Data; 2020. https://ourworldindata.org/coronavirus
Kaur RJ, Dutta S, Bhardwaj P, Charan J, Dhingra S, Mitra P, Singh K, Yadav D, Sharma P, Misra S. Adverse events reported from COVID-19 vaccine trials: a systematic review. Indian J Clin Biochem. 2021;36(4):427-39. https://doi.org/10.1007/s12291-021-00968-z PMID:33814753 - PMCID:PMC7997788.
Kadali RAK, Janagama R, Peruru S, Malayala SV. Side effects of BNT162b2 mRNA COVID-19 vaccine: a randomized, cross-sectional study with detailed self-reported symptoms from healthcare workers. Int J Infect Dis. 2021;106:376-81. https://doi.org/10.1016/j.ijid.2021.04.047 - PMID: 33866000
PMCID: PMC8049195.
Reinfeld S, Cáceda R, Gil R, Strom H, Chacko M. Can new onset psychosis occur after mRNA based COVID-19 vaccine administration? A case report. Psychiatry Res. 2021;304:114165. https://doi.org/10.1016/j.psychres.2021.114165 PMID:34388513 - PMCID:PMC8349391.
Parker C, Slan A, Shalev D, Critchfield A. Abrupt late-onset psychosis as a presentation of coronavirus 2019 disease (COVID-19): a longitudinal case report. J Psychiatr Pract. 2021;27(2):131-6. https://doi.org/10.1097/PRA.0000000000000533 - PMID:33656820 - PMCID:PMC8043329.
Trivedi MH, DeBattista C, Fawcett J, Nelson C, Osser DN, Stein D, Jobson K. Developing treatment algorithms for unipolar depression in cyberspace: International Psychopharmacology Algorithm Project (IPAP). Psychopharmacol Bull. 1998;34(3):355-9. https://pubmed.ncbi.nlm.nih.gov/9803769/ PMID:9803769.
Bhojani S, Aldana-Bernier L, Sikder M, Pawelzik T. Psychotic disorder after contact with a potentially rabid animal and post-exposure prophylactic anti-rabies treatment. Clin Schizophr Relat Psychoses. 2014 Oct;8(3):149-51. https://doi.org/10.3371/CSRP.BHBE.022213 - PMID: 23446200.
Romeo B, Rari E, Mazari A, Toullec A, Martelli C, Benyamina A. First-episode psychosis following vaccination against yellow fever: a case report. Encephale. 2021;47(6):630-1. https://doi.org/10.1016/j.encep.2020.09.009 - PMID:33541715.
Yesilkaya UH, Sen M, Tasdemir BG. A novel adverse effect of the BNT162b2 mRNA vaccine: first episode of acute mania with psychotic features. Brain Behav Immun Health. 2021;18:100363. https://doi.org/10.1016/j.bbih.2021.100363 - PMID:34632429 PMCID:PMC8492001.
Grover S, Rani S, Kohat K, Kathiravan S, Patel G, Sahoo S, Mehra A, Singh S, Bhadada S. First episode psychosis following receipt of first dose of COVID-19 vaccine: a case report. Schizophr Res. 2022;241:70-1. https://doi.org/10.1016/j.schres.2022.01.025 PMID: 35091388 - PMCID: PMC8784614.
Alonso-Lana S, Marquié M, Ruiz A, Boada M. Cognitive and neuropsychiatric manifestations of COVID-19 and effects on elderly individuals with dementia. Front Aging Neurosci. 2020;12:588872. https://doi.org/10.3389/fnagi.2020.588872 - PMID:33192483 PMCID:PMC7649130.
Valdés-Florido MJ, López-Díaz A, Palermo-Zeballos FJ, Martínez-Molina I, Martín-Gil VE, Crespo-Facorro B, Ruiz-Veguilla M. Reactive psychoses in the context of the COVID-19 pandemic: clinical perspectives from a case series. Rev Psiquiatr Salud Ment. 2020;13(2):90-4. https://doi.org/10.1016/j.rpsm.2020.04.009 PMID:32389516 - PMCID:PMC7183984.
Balasubramanian I, Faheem A, Padhy SK, Menon V. Psychiatric adverse reactions to COVID-19 vaccines: a rapid review of published case reports. Asian J Psychiatr. 2022;71:103129. https://doi.org/10.1016/j.ajp.2022.103129 - PMID: 35447503 PMCID: PMC9006421.
Borovina T, Popović J, Mastelić T, Sučević Ercegovac M, Kustura L, Uglešić B, Glavina T. First episode of psychosis following the COVID-19 vaccination: a case series. Psychiatr Danub. 2022;34(2):377-380. https://doi.org/10.24869/psyd.2022.377 PMID:35772162.
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Copyright (c) 2023 Mariel Vendramel Neves, Jessica Jamile Simon, Jorge Henna Neto, Carlos von Krakauer Hübner, Elaine Henna
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