Structural changes of the splenium could be associated with insomnia, irritability, behavioral changes, and psychosis. No corticosteroid was administered, which supports the hypothesis that the manic symptoms may be related to the infection itself. Possible risk factors for mania: – COVID-19 related neuroinflammation and release of pro-inflammatory cytokines in the CNS (TNF-a, IL-1 and IL-6). Here, TNF is linked to insomnia.