Neuropsychiatric manifestations of COVID-19 may be a secondary phenomenon rather than the result of direct brain infection; possible mechanisms include Encephalopathy secondary to factors common in severe illness and to complications that occur during intensive care (eg, hypoxia, electrolyte abnormalities, liver and renal dysfunction) A viral-induced immune reaction and autoimmunity Possibly certain COVID-specific complications, such as vascular endothelial damage, a hyperinflammatory state, and / or coagulopathy Acute, severe COVID-19 often causes systemic hypoxemia and sometimes hypoxic encephalopathy, which has numerous well-known neuropsychiatric manifestations and sequelae, including deficits in cognition and memory, personality changes, and motor impairment.