Researchers Say Hallucinations May Be a COVID-19 Symptom

By Nancy Jiang ’23

Staff Writer

Content Warning: This article contains mention of suicide. 

As of Sept. 22, there are 7.4 million active COVID-19 cases worldwide, with 2.5 million confirmed in the United States. In addition to symptoms of COVID-19 such as fever, headache and respiratory issues, neurologists have discovered that the virus can seriously impact patients’ mental health. 

Neurologists wondered what impact, if any, the virus had on brains. Apart from the drastic increase in the appearance of stress-driven psychological disorders during quarantine, life-threatening neurological symptoms have also emerged for COVID-19 patients. A case study published in the journal Psychosomatics reported a patient who experienced command suicidal hallucination, driven to drink bleach from the kitchen. (This was before President Donald Trump suggested drinking bleach as a potential cure for COVID-19.) According to the patient, he was compelled by a loud and forceful command from an unrecognizable voice, not suicidal intentions. This patient had no prior history of medical or psychiatric illnesses. However, after being saved from ingesting bleach, he remained uncooperative toward the medical team and did not admit to having auditory hallucinations until his 12th day in the hospital. Moreover, his COVID-19 infection developed soon after. Neurologists considered his auditory hallucination to be the first symptom of the virus.          

Other patients have also developed delirium (similar to hallucination, patients develop confused thinking and reduced awareness toward their surroundings) and other neurological manifestations after their coronavirus infections. In another case study published in the British Journal of Psychiatry Open, two days after a patient was hospitalized for COVID-19, she started to become overly alert toward her surroundings and manifested multiple signs of hallucination, saying that the nurses and staff were trying to kill her and regarding her cat as a lion. She behaved abnormally, constantly washing her phone in the sink or brushing her teeth with soap and water. Deficiency in fluency and memory was recorded 10 days after she was hospitalized. She recovered after 52 days with no more ongoing symptoms.

Looking back at one of the first case series from Wuhan, China, published in the journal of JAMA Neurology at the start of 2020, out of 214 people, 36.4 percent had experienced neurological symptoms. According to a study design published in the journal Neurocritical Care, evidence suggests that the SARS-CoV-2 virus can affect the human brain, possibly by passing through the brain-blood barrier (part of the neuroimmune system that prevents foreign solutes in the blood — in this case, the virus from entering the central nervous system) and further cause neuropsychiatric problems. 

Although not as common as the respiratory symptoms, the neuropsychiatric impact of COVID-19 has become a new point of study for some medical professionals, and something to be aware of for those monitoring symptoms. The National Institute of Neurological Disorders and Stroke is providing funding for continued research into the neurological symptoms of COVID-19.