COVID-19 and Psychotic Symptoms: the View from Psychiatric Immunology

TLDR: In this article, the authors explore the immunological underpinnings of psychosis in the COVID-19 patients and find that immunological abnormalities are primarily attributed to the pathophysiology of COVID19 infection, medications used, and stress.

Abstract: Purpose of review To explore the immunological underpinnings of psychosis in the COVID-19 patients. Recent findings COVID-19 pandemic led to a surge in psychiatric morbidities, including psychosis. Various putative biological and psychosocial changes have been implicated in COVID-19-related psychosis. COVID-19 is a proinflammatory state. Alterations in immunological processes both as a direct consequence of infection or secondary to the hyperimmune response heuristically explain the etiopathogenesis of psychosis in the affected individual. The uses of immunosuppressant and immunomodulatory drugs may be the other moderators of a psychotic presentation in COVID-19 patients. Evidence to substantiate this hypothesis is still lacking however, which further studies should address. Because of its management implications, a better understanding of the involved immunological mechanisms becomes extremely important. Summary Evidence suggests a putative role of immunological alterations in the pathogenesis of COVID-19-related psychosis. The immunological abnormalities are primarily attributed to the pathophysiology of COVID-19 infection, medications used, and stress.