Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr 11:14:1102450.
doi: 10.3389/fpsyt.2023.1102450. eCollection 2023.

First-episode mania after COVID-19: A case series in Iran

Mahdieh Saeidi  1 , Tara Rezvankhah  1 , Victor Pereira-Sanchez  2 , Maryam Rafieian  1 , Behnam Shariati  1 , Soode Tajik Esmaeeli  1 , Maziar Emamikhah  1 , Kaveh Alavi  1 , Amir Shabani  1 , Shiva Soraya  1 , Fatemeh Kashaninasab  1 , Fatemeh Sadat Mirfazeli  1
Affiliations

First-episode mania after COVID-19: A case series in Iran

Mahdieh Saeidi et al. Front Psychiatry. .

Abstract

Background: Increasing reports of manic episodes in patients during acute infection with COVID-19 have been documented since the pandemic began, including individuals without a previous personal or family history of bipolar disorder. As infections and autoimmunity have putative roles in bipolar disorder, we aimed to document the clinical presentations, associated stressors, family aggregation patterns, and brain imaging and electroencephalographic correlates with a series of patients with episodes of mania that emerged shortly after COVID-19 infections.

Methods: We obtained all relevant clinical information from 12 patients whose first manic episode started within a month of COVID-19 infection and were treated at Rasool-e-Akram hospital and Iran psychiatric hospital, two tertiary medical centers in Tehran, Iran, in 2021.

Results: Patients had a mean age of 44. The interval between the onset of symptoms of COVID and mania ranged between 0 and 28 days (mean: 16.25, median: 14 days); it was observed to be shorter in patients with a family history of mood disorders but not in those receiving corticosteroids. Alongside a descriptive overview of our sample, we provide detailed narrative descriptions of two of the cases for illustrative purposes and discuss our observations in the context of other cases reported elsewhere and the state-of-the-art regarding infectious diseases, COVID-19, and bipolar disorder as reported in previous literature.

Conclusion: Our case series documents observational and naturalistic evidence from a dozen of cases of mania in the context of acute COVID-19, which, while limited, calls for analytical research of the phenomenon, and points at a family history of bipolar disorder and the use of corticosteroids as factors for particular focus.

Keywords: COVID-19; bipolar disorder; first-episode mania; mania; pandemic.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.The handling editor RF declared past collaborations with one of the authors VP-S.

References

    1. Ahmad I, Rathore FA. Neurological manifestations and complications of COVID-19: a literature review. J Clin Neurosci. (2020) 77:8–12. doi: 10.1016/j.jocn.2020.05.017, PMID: - DOI - PMC - PubMed
    1. de Sousa Moreira JL, Barbosa SMB, Vieira JG, Chaves NCB, Felix EBG, Feitosa PWG, et al. . The psychiatric and neuropsychiatric repercussions associated with severe infections of COVID-19 and other coronaviruses. Prog Neuro-Psychopharmacol Biol Psychiatry. (2021) 106:110159. doi: 10.1016/j.pnpbp.2020.110159, PMID: - DOI - PMC - PubMed
    1. He X, Zhang D, Zhang L, Zheng X, Zhang G, Pan K, et al. . Neurological and psychiatric presentations associated with COVID-19. Eur Arch Psychiatry Clin Neurosci. (2022) 272:41–52. doi: 10.1007/s00406-021-01244-0, PMID: - DOI - PMC - PubMed
    1. Nakamura ZM, Nash RP, Laughon SL, Rosenstein DL. Neuropsychiatric complications of COVID-19. Curr Psychiatry Rep. (2021) 23:1–9. doi: 10.1007/s11920-021-01237-9 - DOI - PMC - PubMed
    1. Cascella M, De Blasio E. Pathophysiology of COVID-19-associated neurotoxicity In: Features and Management of Acute and Chronic Neuro-Covid. Berlin: Springer; (2022). 1–41.