Abstract
Psychotic disorders in patients with Parkinson's disease are usually associated with poor cognitive performance, comorbidities, and changes in treatment regime. Despite the recognition of cognitive deficit as a major risk factor for psychosis in Parkinson's disease, psychotic events have been reported in patients without dementia. SARS-CoV-2 is now recognized as a harmful invader of the nervous system, and defining its consequences still requires multidirectional research. Patients with Parkinson's disease may develop psychosis during COVID-19 infection. According to our observation, psychotic disorder seems to be an isolated manifestation of SARS-CoV-2 infection in Parkinson's disease. In this article, we present two clinical cases of non-demented patients with Parkinson's disease who underwent full vaccination against SARS-CoV-2. The patients were on stable antiparkinsonian medication, had no previous psychiatric disturbances, and developed psychosis as a consequence of COVID-19 without any other clinical signs of infection; no recurrent psychotic disorders were registered during the one-year follow-up. The discussion on diagnostic difficulties and treatment options includes a review of the literature. We recommend to perform reverse transcription polymerase chain reaction (RT-PCR) swab testing for SARS-CoV-2 in patients with Parkinson's disease who develop acute psychosis.
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