Therapeutic Challeng es of COVID-19 in a Patient Admitted to the Psychosomatic Ward: A Case Report

Abstract

Introduction: Early diagnosis of 2019-nCoV infection is of great importance and can be challenging in psychiatric patients, especially when a mental illness such as somatoform disorder causes one or more bodily symptoms because the clinical features of this group of patients may be more confusing compared with non-psychiatric patients. On the other hand, treating this infection in psychiatric patients faces some challenges. Case Presentation: A case of the 2019-nCoV infection is reported in a patient who was admitted to the psychosomatic ward with a diagnosis of somatic symptom disorder. The patient had a history of numerous unexplained physical complaints, usually complained of some new physical symptoms when informed of the time of his discharge. Although the possibility of misdiagnosis was high, based on examinations and some paraclinical evaluations, the patient underwent a simultaneous diagnosis of COVID-19. Unlike usual, he did not complain of any new physical complaints after informing of the 2019-nCoV infection and was willing to be discharged. Some diagnostic and therapeutic challenges regarding 2019-nCoV infection in the patient were examined. Conclusions: There are three clinically relevant learning points to be noted from this case report. Firstly, the importance of paying attention to the patient's complaints in any mental patient, even disorders related to unexplained physical complaints. Secondly, the introduction highlights the differences in the care of patients with COVID-19 between psychiatric and non-psychiatric patients and the need for a multidisciplinary approach. Third, this introduction identifies a crucial diagnostic role for CT thorax in symptomatic patients with suspected COVID-19 because the false-negative rate with RT-PCR COVID-19 nasopharyngeal swabs is high.