International Journal of Health Sciences and Research Vol.10; Issue: 9; September 2020 Website: www.ijhsr.org Case Report ISSN: 2249-9571 International Journal of Health Sciences and Research (www.ijhsr.org) 248 Vol.10; Issue: 9; September 2020 “Kill Me” COVID-19 Patient Says: A Case Report Alfateh Sayed M. Noor 1 , Abdulrahman M. Alharthy 1 , Ahmed Rajab 1 , Waleed Th. Aletreby 1 , Khalid Hamza 2 , Essam Hashish 3 , Ahmed F. Mady 1,4 1 Critical Care Department, King Saud Medical City, Riyadh, KSA. 2 Pulmonology Department, Alquaiayah General Hospital, Riyadh, KSA 3 Psychology Department, Alquaiayah General Hospital, Riyadh, KSA 4 Anesthesia Department, Faculty of Medicine, Tanta University, Tanta, Egypt. Corresponding Author: Waleed Th. Aletreby ABSTRACT Ominous new data suggest that COVID-19 may be linked to psychological and neurological conditions including strokes and psychosis, along with alerting reports of possible rise in suicidal rates due to several factors. This rare case report outlines and documents delirium and suicidal ideation in a sixty-year old patient with critical covid-19 pneumonia. The patient’s condition was diagnosed early, and successfully treated in a COVID-19 specialized intensive care unit of King Saud medical city, in Saudi Arabia. This case report highlights the possible association between COVID-19 infection and psychological manifestations, with stress upon the importance of early recognition, through effective communication with patients, and management in a multidisciplinary approach. Key words: COVID-19, Case Report, ICU, Psychological. INTRODUCTION COVID-19 causing respiratory symptoms was first identified in December 2019 in China. (1) The World Health Organization (WHO) declared the outbreak of COVID-19 a pandemic on the 11 March 2020. (2) Since then, its presentation and effects have been the subject of many publications and studies. The agreement until now that its presentation is variable ranging from mild disease to severe and life-threatening presentation, few studies concluded that covid-19 may infect nervous system and skeletal muscles as well as the respiratory tract. (3,4) In those with severe infection, neurologic involvement is greater, which includes acute cerebrovascular diseases, and impaired consciousness. (3) A study in UK found that altered mental status was the second most common presentation in COVID-19 patients, comprising encephalopathy or encephalitis and primary psychiatric diagnoses. (4) Where several studies addressed psychological impact of COVID-19 on healthcare workers, (5) limited data exist on the psychological impact on COVID-19 patients themselves, this lack of evidence in this field makes it an attraction spot for research, that calls for resourcing by research funders, to shed more light on the psychological and social impacts of the pandemic, (6) even less studied is the possible rise in suicidal rates and self-harm, that was suggested in view of similar observations during previous pandemics, (7) and attributed to fear, self-isolation, physical distancing, and social stigma towards individuals with COVID-19 infection, particularly among those with already existing psychiatric disorders. Hence, this case report aims to enlighten about the suicidal ideation of a critically ill COVID-19 patient, with stress on the importance of early recognition and intervention.