First off, innocent individuals would not resist proving that they did nothing wrong and would have no problem doing an exchange of information or even helping someone find out what truly is responsible, Would any reasonably minded person disagree with that theory??? feel free to comment if anyone has anything that can counter that theory.

Role of Isolation and Lack of Support in Increased Auditory Hallucinations During COVID-19

Social isolation and lack of support played a significant role in the increase of auditory hallucinations and other psychotic symptoms during the COVID-19 pandemic.

Studies found a direct association between the conditions of self-isolation—such as the duration of isolation, limited living space, and infrequent social interactions—and the frequency of psychotic symptoms, including hallucinations1 2. The longer individuals went without conversation or leaving their homes, the more likely they were to report increases in psychotic symptoms.
The presence of hallucinations and paranoia was observed particularly in people who experienced negative emotions (such as fear of COVID-19) and had low trust in authorities1 2 6. This suggests that not only isolation itself, but also the psychological stress and lack of social support, heightened vulnerability to these symptoms.
Case reports and reviews highlight that individuals without previous psychiatric history developed severe psychotic symptoms, including auditory hallucinations, after periods of isolation and COVID-19 infection3 5 7. These symptoms could be severe and persistent, sometimes requiring inpatient psychiatric care.
Mistrust in government policy and heightened fear related to the pandemic further increased the risk of developing paranoia and hallucinations, pointing to the compounding effect of psychological stressors and social isolation6.

In summary, enforced isolation and lack of social support during the pandemic were significant contributors to the rise in auditory hallucinations, acting both as direct stressors and by amplifying underlying fears and negative emotions1 2 6.

Auditory Hallucinations Following COVID-19: A Review of Reported Cases

Introduction

The COVID-19 pandemic has been associated with a range of neuropsychiatric manifestations, including auditory hallucinations. This report examines the available evidence regarding the increase in reported cases of auditory hallucinations since the onset of the COVID-19 pandemic, exploring both the direct neuropsychiatric effects of SARS-CoV-2 infection and the broader psychological impacts of the pandemic.

Prevalence of Auditory Hallucinations in COVID-19 Patients

General Findings

Research indicates that auditory hallucinations have emerged as a significant neuropsychiatric symptom among COVID-19 patients, though precise global numbers remain difficult to establish12. Studies have documented that approximately 11% of COVID-19 patients reported experiencing some form of hallucinations, with auditory hallucinations specifically occurring in about 8% of cases3.

In patients with COVID-19-induced psychosis, auditory hallucinations were found to be the most common type of hallucination, occurring in approximately 60% of these cases4. Among those experiencing post-COVID psychosis, auditory hallucinations were reported in 54.2% of cases, significantly higher than visual hallucinations which occurred in only 12.5% of cases5.

Hospitalized Patients

The prevalence of hallucinations appears to be particularly high among patients requiring hospitalization for COVID-19:

· A study of patients transferred to inpatient post-COVID-19 rehabilitation found that more than 21% experienced hallucinations of various types6.

· Among these patients with hallucinations, 62.5% reported experiencing auditory sensations specifically6.

· Patients who experienced hallucinations typically had longer hospital stays (mean 116.4 days vs. 49.3 days) and more severe COVID-19 cases compared to those without hallucinations6.

Increase in Psychosis Cases Since the Pandemic

While specific global numbers for auditory hallucinations alone are not comprehensively documented, there is substantial evidence of an overall increase in psychosis cases (which often include auditory hallucinations as a symptom) since the beginning of the pandemic:

· A comparative study of pre-pandemic versus pandemic psychiatric admissions found a 22.9% increase in psychosis cases during the pandemic compared to pre-pandemic times7.

· Research conducted in Italy documented a 29.6% increase in psychiatric hospitalizations for incident cases of psychosis compared to before the pandemic8.

· The transition rate to full-blown psychosis in individuals at clinical high risk approximately doubled during the pandemic, from the typical pre-pandemic rate of around 15% to approximately 30%9.

Patient Demographics

COVID-19-related psychosis with auditory hallucinations has been observed to affect individuals who typically fall outside the usual demographic profile for first-episode psychosis:

· The mean age for onset of psychotic symptoms was 43.4 years for men and 40.3 years for women, which is notably higher than the typical age of onset for primary psychotic disorders1011.

· Approximately 69% of patients had no prior history of psychiatric disorders, suggesting that COVID-19 may trigger new-onset psychosis in previously healthy individuals10.

· Most patients had mild COVID-19-related symptoms, with only about 26.3% presenting with moderate to severe COVID-19-related disease and complications1011.

Clinical Presentation

The clinical presentation of COVID-19-related auditory hallucinations often includes:

· Command auditory hallucinations in some cases, including voices commanding self-harm10.

· Paranoid delusions frequently co-occurring with the auditory hallucinations1213.

· Persistence of symptoms for weeks or months after recovery from the acute infection in some cases214.

Risk Factors for Developing Auditory Hallucinations

Several factors appear to increase the risk of developing auditory hallucinations and other psychotic symptoms following COVID-19 infection:

· Severity of initial COVID-19 symptoms: Adults with more severe initial COVID-19 symptoms were more likely to have long-term neuropsychiatric symptoms, with 27.8% of those reporting severe COVID-19 symptoms developing such complications15.

· Hospitalization status: Patients requiring ICU admission and mechanical ventilation showed higher rates of psychotic symptoms including hallucinations1216.

· Socioeconomic factors: Higher levels of material deprivation before the pandemic predicted a higher load of chronic post-COVID neuropsychiatric symptoms17.

· Vaccination status: The lack of COVID vaccination before infection was associated with a higher risk of developing neuropsychiatric symptoms, including those in the cognitive-fatigue cluster17.

Neuropsychiatric Symptoms Beyond Auditory Hallucinations

The broader context of neuropsychiatric manifestations following COVID-19 includes:

· More than 1 in 10 adults (11.3%, representing approximately 902,700 individuals in one national study) experienced long-term neuropsychiatric symptoms15.

· The most prevalent neuropsychiatric symptoms included sleep disturbance (27.4%), fatigue (24.4%), objective cognitive impairment (20.2%), anxiety (19.1%), and post-traumatic stress (15.7%)18.

· In the first year of the COVID-19 pandemic, the global prevalence of anxiety and depression increased by 25% according to the World Health Organization19.

· A retrospective cohort study reported that among 236,379 patients diagnosed with COVID-19, the estimated incidence at 6 months post-COVID was 1.40% for psychotic disorders (0.42% for first such diagnosis)20.

Potential Mechanisms

Several mechanisms have been proposed to explain the link between COVID-19 and auditory hallucinations:

· Direct viral infiltration of the central nervous system triggering neuroinflammatory reactions421.

· Peripheral hypercytokinemia disrupting the blood-brain barrier and causing an imbalance in neurotransmitters4.

· Psychological stress related to isolation, fear, and uncertainty during the pandemic22.

· Chronic low levels of oxygen to the brain due to respiratory complications in severe COVID-19 cases12.

Treatment and Outcomes

Most patients with COVID-19-related psychosis including auditory hallucinations responded well to treatment:

· The majority of patients responded to low-to-moderate doses of antipsychotics with quick recovery10.

· Complete resolution or significant improvement of psychotic symptoms occurred in approximately 72% of cases11.

· However, some patients experienced partial improvement with residual psychotic symptoms, highlighting the need for careful monitoring and longer follow-up10.

Conclusion

While precise global numbers quantifying the exact increase in auditory hallucinations since the COVID-19 pandemic are not available, the evidence clearly indicates a significant rise in psychotic symptoms, including auditory hallucinations, both in individuals infected with SARS-CoV-2 and in the general population affected by pandemic-related stressors7 819. The approximately 22-30% increase in psychosis cases, with auditory hallucinations being present in 54-60% of these cases, suggests a substantial increase in the overall burden of auditory hallucinations since the beginning of the pandemic10 57.

The emergence of these symptoms in individuals without prior psychiatric history, often at ages atypical for first-episode psychosis, underscores the need for healthcare providers to be vigilant about neuropsychiatric manifestations in COVID-19 patients and survivors1011. Further research is needed to establish more precise epidemiological data and to develop targeted interventions for this growing clinical challenge2218.

1. https://pmc.ncbi.nlm.nih.gov/articles/PMC9938787/

2. https://pmc.ncbi.nlm.nih.gov/articles/PMC11645164/

3. https://www.sciencedirect.com/science/article/pii/S2590109522000660

4. https://www.psychiatrist.com/pcc/new-onset-psychosis-secondary-to-covid-19-infection/

5. https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2024.1360338/full

6. https://www.neurologyadvisor.com/news/hallucinations-common-patients-covid-19-inpatient-rehabilitation/

7. https://pubmed.ncbi.nlm.nih.gov/37503505/

8. https://pmc.ncbi.nlm.nih.gov/articles/PMC8628604/

9. https://www.jpsychopathol.it/article/view/657

10. https://pmc.ncbi.nlm.nih.gov/articles/PMC9248300/

11. https://pmc.ncbi.nlm.nih.gov/articles/PMC9865730/

12. https://www.aarp.org/health/conditions-treatments/covid-hallucinations/