Neuropsychiatric Manifestations of COVID-19: A 2023 Update

For the past two years, members of our team have presented workshops on the acute and chronic neuropsychiatric effects of COVID-19 that have been well-attended and -received. As COVID-19 becomes an endemic disease, CL psychiatrists will continue to wrestle with acute and long-term sequelae of the illness. Recent reports indicate a growing number of patients developing encephalitities in the setting of a recent COVID infection, and many patients continue to struggle with persistent symptoms of cognitive dysfunction, dysautonomia and fatigue. At the same time, it is unclear whether we are closer to understanding the pathophysiology, as new theories emerge regarding molecular mimicry or the gut-brain axis. Finally, the neuropsychiatric effects of COVID on children and adolescents are becoming clearer with both acute presentations (new-onset psychosis and catatonia) and longer-term sequelae such as memory deficits.

This year, we will again present an overview of acute and chronic neuropsychiatric complications of infection with SARS-CoV-2, with a focus on new literature that has emerged over the past year. Consistent with the meeting’s theme, we will discuss COVID across the lifespan, including specific presentations on COVID in children and older adults. We will focus on an evidence-based approach to inform our clinical recommendations. We will also highlight related healthcare disparities and particularly the impact of COVID-19 on marginalized and disenfranchised populations. As before, all members of our workgroup remain actively involved in research or scholarship related to COVID-19 and will present updated findings from their own work in addition to reviewing the recent literature. We hope that presenting this as a live symposium will allow for a rich Q&A discussion.

Scott Beach, MD, is an Associate Professor at Harvard Medical School and an attending psychiatrist on the MGH CL service. He will review acute neuropsychiatric complications of COVID, including delirium, psychosis and catatonia spectrum syndromes, with a special focus on post-COVID encephalitis.

Erica Baller, MD, MS, is an Assistant Professor of Psychiatry in the Neurodevelopment and Psychosis Section, and an inpatient CL psychiatrist at the University of Pennsylvania. Dr. Baller will provide an update on our current understanding of the pathophysiological mechanisms for how SARS-CoV-2 affects the central nervous system. She will focus on emerging research into autoimmune mechanisms and how they contribute to encephalitis in acute COVID-19.

Durga Roy, MD is the Director of the Johns Hopkins Neuropsychiatry clinic and is collaborating with the Johns Hopkins Post-COVID-19 care clinic. Dr. Roy will review clinical findings, phenomenology and longitudinal studies of long COVID, proposed neurocircuitry of brain fog and cognitive deficits after COVID, particularly in the elderly, and review current trials in progress for potential treatment modalities.

Laura Markley MD, is Medical Director of the CL Service at Akron Children’s hospital and an Associate Professor of Psychiatry and Pediatrics at Northeastern Ohio Medical University. Dr. Markley will review pediatric complications of acute COVID infection, as well as longer- term neuropsychiatric and developmental concerns following infection.