| Psychomotor symptoms, cognitive impairments and suicidal thoughts after COVID-19 infection: a case report and the possible allostatic mechanism |
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Ying Lin1,2, Chen Lin3, Jason Hong-Yi Chang1, Dai-Lun Chiang4, Feipei Lai2, Chen-Ju Lin1,5 |
1Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
2Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
3Department of Biomedical Sciences and Engineering, National Central University, Chunli, Taiwan
4Financial Technology Applications Program, Ming Chuan University, Taoyuan, Taiwan
5Institute of Health and Welfare Policy, National Yang-Ming Chiao-Tung University, Taipei, Taiwan |
Correspondence:
Chen-Ju Lin,
Email: gloria993130@gmail.com
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Received: 12 February 2024 • Revised: 30 April 2024 • Accepted: 4 May 2024 |
| Abstract |
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Although neuropsychiatric manifestations are common in survivors of coronavirus disease 2019 (COVID-19), the pathophysiology is not yet elucidated. Here we describe the case of a geriatric inpatient who developed postCOVID depression with psychomotor retardation, anxiety, hopelessness, executive function problems, and suicidal ideations. The language problems and cognitive impairments coemerged with the motor problems. We propose a mechanism associated with problems in energy prediction and regulation in which the coronavirus infection, which causes neuroinflammation and viral activity in the nervous system, interferes with the reward pathway and sensory prediction process. Sigma-1 receptor agonists such as sertraline may regulate energy expenditure and, thus, be beneficial to the process. The treatment improvements in our patient included those in the autonomic nervous system, activity, and circadian rhythm. |
| Key Words:
COVID-19, Post COVID depression, Older adult, Long COVID, allostasis |
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