Introduction: Catatonia is a psychomotor syndrome that presents with severe symptoms which can lead to dangerous and lethal conditions if not diagnosed and treated properly. SARS-- CoV-2 is a positive-sense single-stranded RNA virus that can occur in severe cases with acute pneumonia, ARDS, sepsis and septic shock. In these cases, ICU admission is necessary.

Case Summary: A 59-year-old Caucasian man with septic shock and bilateral interstitial pneumonia from SARS-CoV-2 and schizotypal personality disorder presented with catatonic behaviour manifested by soporous state, response to intense painful stimuli with the opening of the eyes, execution of simple verbal commands, maintenance of the same position, catalepsy, immobility, rigidity and mutism. At the same time, there were symptoms of septic shock and catatonic symptoms, causing greater difficulty in the correct formulation of the diagnosis. During the course of his hospitalization, he was treated with asenapine 20 mg/day. The catatonia responded rapidly and significantly to the asenapine.

Discussion: To date, the pathophysiology of catatonia is unclear, and few guidelines are available for the treatment of catatonia. In the literature, studies have reported the efficacy of benzodiazepines such as lorazepam and diazepam, GABAA agonists such as zolpidem, NMDA receptor antagonists such as memantine, antidepressant SSRIs such as fluoxetine and paroxetine, and antipsychotics such as olanzapine, clozapine and aripiprazole. We demonstrate that the antipsychotic asenapine is also effective in treating catatonic symptoms in psychiatric disorders.

Conclusion: Asenapine produced a rapid and significant reduction in catatonic symptoms in our patient with schizotypal personality disorder.

简介：紧张症是一种精神运动综合征，表现为严重的症状，如果不及时诊断和治疗，可能导致危险和致命的情况。SARS--CoV-2 是一种正链单链 RNA 病毒，可发生在急性肺炎、ARDS、败血症和感染性休克的严重病例中。在这些情况下，入住 ICU 是必要的。

病例摘要：一名 59 岁白人男性，患有 SARS-CoV-2 感染性休克和双侧间质性肺炎和分裂型人格障碍，表现为紧张性行为，表现为昏睡状态、睁眼时对强烈疼痛刺激做出反应、处决简单的口头命令，保持相同的姿势，僵住，不动，僵硬和缄默。同时，出现感染性休克症状和紧张症症状，给正确制定诊断造成更大困难。在住院期间，他接受了阿塞那平 20 毫克/天的治疗。紧张症对阿塞那平反应迅速且显着。

讨论：迄今为止，紧张症的病理生理学尚不清楚，可用于治疗紧张症的指南很少。在文献中，研究报道了苯二氮卓类药物（如劳拉西泮和地西泮）、GABAA 激动剂（如唑吡坦）、NMDA 受体拮抗剂（如美金刚）、抗抑郁药 SSRIs（如氟西汀和帕罗西汀）以及抗精神病药（如奥氮平、氯氮平和阿立哌唑）的疗效。我们证明抗精神病药阿塞那平也可有效治疗精神疾病的紧张症症状。

结论：阿塞那平使我们的分裂型人格障碍患者的紧张症症状迅速显着减轻。