[
    {
        "id": "osp-2504",
        "type": "article-journal",
        "title": "A Letter in Reply: COVID-19 Induced New-onset Psychosis",
        "author": [
            {
                "family": "Al-Huseini",
                "given": "Salim"
            },
            {
                "family": "Al-Adawi",
                "given": "Samir"
            }
        ],
        "URL": "https://omanscience.com/en/articles/a-letter-in-reply-covid-19-induced-new-onset-psychosis",
        "language": "en",
        "issued": {
            "date-parts": [
                [
                    2022
                ]
            ]
        },
        "container-title": "Oman Medical Journal",
        "DOI": "10.5001/omj.2022.60",
        "publisher": "Oman Medical Specialty Board",
        "ISSN": "1999-768X",
        "abstract": "We appreciate the comments from Al-Mendalawi on our case report, and on the merit of exploring cytokine and immunosuppression in the context of psychosis. In our case report, we overlooked the literature suggesting the potential role of cytokine and immunosuppression in the development of psychosis despite emerging evidence that cytokine profile might be critically associated with COVID-19 and its severity. In line with Al-Mendalawi’s assertion, infection by SARS-CoV-2 virus has been widely established to trigger activation of central and peripheral cytokine which may result in cytokine storms and weakening of the blood-brain barrier. Such pathological processes compromise the integrity of the brain circuits leading to consequences such as the onset of obscured consciousness and conditions resembling psychosis. Along with this, the occurrence of overt neurological events as a result of COVID-19 has been observed including triggering of acute and ischemic strokes. The hallmarks of encephalopathy or encephalitis via brain scans have been documented. It remains to be seen whether the observed psychosis results from a specific degradation of the brain circuits or is part of a global breakdown of the brain processes. More studies are needed to examine how the cytokine storm interferes with the molecular activity at synapses and other brain circuitries to lead to psychosis. If the hypothesis of the link between COVID-19 and neuroimmunology withstands further scrutiny, then the potential of bringing psychoneuroimmunology into our quest to understand psychosis will potentially open a new chapter in our understanding of psychiatric disorders. We are grateful to Al-Mendalawi for bringing this matter to our attention."
    }
]