Can behavioral changes observed in COVID-19 patients be explained by primary viral invasion of the brain?

Bottom Line:

Since behavioral changes can be the first presentation in patients with COVID-19, it may be beneficial to expand screening criteria to include neurological symptoms.


Beach, S. et al. Delirium in COVID-19: A case series and exploration of potential mechanisms for central nervous system involvement. General Hospital Psychiatry (2020). DOI: 10.1016/j.genhosppsych.2020.05.008

Date Published:

22 May 2020


In current screening protocols for COVID-19, hospitals and clinics focus mainly on respiratory and GI symptoms. However, there have been numerous cases with atypical presentations including an estimated 1/3 of COVID-19 patients presenting with behavioral symptoms. This study looked into four COVID-19 positive cases where the patients presented with delirium (a change in the brain that results in confusion developed over a short period of time). Only one patient experienced respiratory symptoms, and none had GI symptoms. Other observed changes in mental functioning included a loss of speech and movement. A potential explanation for these symptoms involve viral invasion through neural connections between the brain and receptors in the lungs. Further research is necessary to understand the effect of COVID-19 on the brain.

Summary by: Eugenia Yeung