First manic episode after covid-19 infection: case series

Background: In January 2020, the World Health Organization declared the Severe Acute Respiratory Syndrome Coronavirus 2 to be a pandemic. Since then, studies have demonstrated the potential of this virus to cause changes in the central nervous system and psychiatric symptoms. Some reports associating the Severe Acute Respiratory Syndrome Coronavirus 2 infection and manic symptoms have been published. Objective: Present the characteristics of manic syndrome after the Severe Acute Respiratory Syndrome Coronavirus 2 infection and provide ways to better prevent risks and identify this syndrome. Methods: Data from multiple sources of information, including reviews of medical records, direct examinations of the subjects and interviews with patients and their families, were collected and analyzed. Results: Six cases of Covid-19 infection with a first manic episode and no previous psychiatric history were reported. Conclusion: The findings of this study suggest that for mild symptomatic cases, the use of corticosteroids should be disregarded due to the risk of inducing a manic episode. The use of anticoagulation in severe conditions is reinforced by the finding of microlesions of probable microvascular etiology in one of the patients. All patients in the study had psychotic symptoms with symptom onset within the first 30 days of infection.