A 36-year-old woman worki...

A 36-year-old woman working in a skilled nursing home with a distant history of erythema multiforme and no prior psychiatric history was diagnosed with COVID-19 by a nasopharyngeal swab. When COVID-19 was diagnosed, the most noteworthy symptoms were rhinorrhoea and nasal congestion without any accompanying dyspnea or evidence of anosmia or dysgeusia. She was observed to experience an acute, quickly progressing change in her behaviour four days after the onset of upper respiratory symptoms, characterized by strong persecutory delusions and decreased sleep. Her hallucinations mainly targeted her partner and were concerned with her children's security and personal wealth. The patient was first brought to the general medical clinic due to the sudden onset of psychosis with an unknown cause and her positive COVID-19 status; however, psychiatry was later consulted for additional assessment and management. She avoided eye contact during her initial psychiatric interview but showed no signs of psychomotor agitation or impairment. On bedside testing, attention, focus, and orientation were all intact.