“The Use of Electroconvulsive Therapy in Neuropsychiatric Complications of COVID-19: A systematic literature review and case report”.

This study reports on the use of electroconvulsive therapy (ECT) in neuropsychiatric symptoms (NPS) associated with COVID-19.
A review of the literature pertaining to the use of ECT in COVID-19 patients with NPS was performed through PubMed, PsycINFO, and MEDLINE. Search terms included “Electroconvulsive Therapy” and “ECT,” combined with “COVID-19” and “SARS-COV-2.” Additionally, we present a case in which ECT was used to achieve complete remission in a patient who developed new onset, treatment-resistant depression, psychosis, and catatonia, associated with COVID-19.
67 articles were reviewed with 3 selected for inclusion. These articles detailed 3 case reports of patients with new onset NPS (mania, psychosis and suicidality, and catatonia) that developed in the context of active COVID-19 and were treated successfully with ECT.
There is a significant prevalence of new onset NPS, some severe and persistent, in COVID-19 patients. ECT, a broad-spectrum treatment that has been found to be effective in various NPS (independent of etiology), is shown in our case report and others, to be safe and effective for NPS associated with COVID-19. Though we identified only 3 other cases in the literature, we believe that the probable anti-inflammatory mechanism of ECT, its safety and tolerability, and the faster time to symptom remission support the need for more research and increased clinician awareness about this life-saving procedure.