与新型冠状病毒感染相关的4例急性而短暂的精神病性障碍病例报告

杨雅琴; 刘娜; 王芳; 黄楠; 李清伟

doi:10.16766/j.cnki.issn.1674-4152.003987

与新型冠状病毒感染相关的4例急性而短暂的精神病性障碍病例报告

doi: 10.16766/j.cnki.issn.1674-4152.003987

杨雅琴¹,
刘娜²,
王芳¹,
黄楠²,
李清伟^{2, 3, ,}

1.
上海市杨浦区精神卫生中心，上海健康医学院附属精神卫生中心，上海 200093
2.
上海交通大学附属精神卫生中心，上海 200030
3.
同济大学附属同济医院精神医学科，上海 200065

基金项目:

上海市卫生健康系统重点扶持学科建设项目 2023ZDFC0502

上海卫生健康系统心身医学重要薄弱学科建设计划 2019ZB0202

详细信息

通讯作者:
李清伟，E-mail：lianocd@tongji.edu.cn

中图分类号: R563.14 R749.1
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出版历程
- 收稿日期: 2024-04-22
- 网络出版日期: 2025-06-30

Four case reports of acute and transient psychotic disorders associated with COVID-19

YANG Yaqin¹,
LIU Na²,
WANG Fang¹,
HUANG Nan²,
LI Qingwei^{2, 3
, ,}

1.
Shanghai Yangpu District Mental Health Center, Shanghai University of Medical & Health Sciences, Shanghai 200093, China

摘要

摘要: 新型冠状病毒(SARS-CoV-2)感染后出现的精神症状多为谵妄、认知功能障碍、创伤后应激障碍以及情绪相关障碍，精神病性症状在临床上较少见。本文报道4例新型冠状病毒感染后出现急性而短暂的精神病性障碍的患者住院治疗及出院后1年的随访情况，并对相关文献进行复习，增加对新型冠状病毒感染后出现精神症状的认识，提高对疾病和症状发生发展的了解，做到早期识别、妥善治疗。
- 新型冠状病毒感染 /
- 精神障碍 /
- 病例报告
Abstract: Psychiatric symptoms following infection with the novel coronavirus (SARS-CoV-2) are frequently observed and may include delirium, cognitive dysfunction, post-traumatic stress disorder and mood-related disorders. Psychiatric symptoms are uncommon in clinical practice. This article presents the case studies of four patients who developed acute and transient psychotic disorders following novel coronavirus infection. It also review the relevant literature to increase awareness of psychotic symptoms after COVID-19, improve understanding of the disease and the development of symptoms, and achieve early recognition and appropriate treatment.
- Coronavirus disease 2019 /
- Psychotic disorder /
- Case reports

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表 1 4例与COVID-19相关的急性精神障碍患者入院时实验室和影像学检查结果

Table 1. Four cases of acute mental disorders associated with COVID-19 were admitted for laboratory and imaging examinations

项目	病例1	病例2	病例3	病例4
性别	女性	女性	女性	女性
年龄(岁)	21	26	21	27
SARS-CoV-2核酸检测	阴性	阴性	阴性	阴性
SpO₂(%)	98	99	99	99
心率(次/min)	76	100	94	112
呼吸(次/ min)	18	16	18	16
血压(mmHg)	108/73	130/80	118/85	100/80
体温(℃)	37.0	37.0	37.2	36.8
WBC(×10⁹/L)	6.04	7.38	6.29	18.92
N%(%)	60.8	49.9	55.8	74.8
CRP(mg/L)	1.7	3.1	4.5	1.7
D-二聚体(μg/mL)	2.0	0.7	0.7	0.7
心肌酶	正常	肌酸激酶: 355 U/L	正常	正常
甲状腺功能	正常	TT3:1.19 nmol/L FT4:28.14 pmol/L	正常	正常
铁蛋白(ng/mL)	219.50	196.40	75.29	56.77
HIV	阴性	阴性	阴性	阴性
TRUST	阴性	阴性	阴性	阴性
尿常规	正常	正常	正常	正常
尿毒品检测	阴性	阴性	阴性	阴性
脑电图	慢波背景，全导中幅慢波散在或阵发性发放(需除外药物、改良电疗影响)	全导低中幅慢波散在或阵发性发放(需除外药物、改良电疗影响)	未见明显异常	未见明显异常
心电图	窦性心动过速	窦性心动过速	正常	窦性心律，QRS电轴右偏，T波改变(Ⅱ、Ⅲ、aVF低平、倒置)
胸部CT	正常	正常	正常	正常
头颅MRI	正常	垂体形态饱满	正常	正常
注：1 mmHg=0.133 kPa。SpO₂为经皮动脉血氧饱和度(percutaneous arterial oxygen saturation)，N%为中性粒细胞百分比(neutrophil percentage)，TT3为总三碘甲状腺原氨酸(total triiodothyronine)，FT4为游离甲状腺素(free thyroxine)，TRUST为梅毒甲苯胺红不加热血清试验(toluidine red unheated serum test)。

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