1887
Volume 2022, Issue 3
  • ISSN: 0253-8253
  • EISSN: 2227-0426

Abstract

Introduction: Coronavirus disease 2019 (COVID-19) can present with various neuropsychiatric manifestations. This study reports on patients with COVID-19 who were referred to the consultation–liaison (CL) psychiatry services in Qatar and compares the clinical and sociodemographic characteristics of those diagnosed with delirium versus other psychiatric diagnoses. Methods: This is a retrospective review of the first 100 consecutive patients with COVID-19 who were referred to the CL services. Results: Within the total cohort (n=100), most patients (92%) were male, and the mean age was 46 years. About 27% of patients had asymptomatic COVID-19, 35% had a past psychiatric history, and 48% reported pandemic related psychosocial stress. Delirium was the most common psychiatric diagnosis (n=29), followed by acute stress reaction/adjustment disorder, depression, mania, anxiety, non-affective psychosis, and dementia. Among patients with delirium, agitation was the most common symptom (76%), 86% were treated with psychotropic medications, and 17% died. Higher age, longer hospital stays, lower oxygen saturation, lower lymphocytic count, and higher C-reactive protein (CRP) values were significantly associated with delirium versus other psychiatric diagnoses. Higher age and lower oxygen saturations predicted delirium.Conclusion: Delirium was associated with a range of clinical variables and had significant mortality, despite the relatively young age of the patients. COVID-19 should be considered in patients presenting with delirium. Finally, early identification and management of delirium should be integral to COVID-19 protocols.

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2022-06-17
2022-09-29
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References

  1. A. Varatharaj, N. Thomas, M.A. Ellul, N. Davies, T.A. Pollak, E.L. Tenorio, et al. Neurological and neuropsychiatric complications of COVID-19 in 153 patients: a UK-wide surveillance study. Lancet Psychiatry 2020; 7:(10): 875–882. PMID: 32593341; PMCID: PMC7316461. https://doi.org/10.1016/S2215-0366(20)30287-X.
    [Google Scholar]
  2. A. Ticinesi, N. Cerundolo, A. Parise, A. Nouvenne, B. Prati, A. Guerra, et al. Delirium in COVID-19: epidemiology and clinical correlations in a large group of patients admitted to an academic hospital. Aging Clin Exp Res 2020;: 32: 2159–2166 (2020). https://doi.org/10.1007/s40520-020-01699-6.
    [Google Scholar]
  3. D. Emmerton & A. Abdelhafiz, A. Delirium in older people with COVID-19: clinical scenario and literature review. SN Compr Clin Med, 1–8. Advance online publication. https://doi.org/10.1007/s42399-020-00474-y.
    [Google Scholar]
  4. MA. Oldham, A.J.C. Slooter & C. Cunningham. Characterising neuropsychiatric disorders in patients with COVID-19. Lancet Psychiatry. 2020;: 7: 932–933.
    [Google Scholar]
  5. M. Taquet M, S. Luciano, JR. Geddes, PJ. Harrison. Bidirectional associations between covid-19 and psychiatric disorder: retrospective cohort studies of 62–354 covid-19 cases in the USA. Lancet Psychiatry 2020 (published online 9 Nov). doi:10.1016/S2215-0366(20)30462-4.
    [Google Scholar]
  6. Y. Iqbal, M. Alabdulla, J. Latoo, R. Kumar, S. Albrahim, O. Wadoo, et al. Mania and hypomania associated with COVID- 19: a series of 15 cases seen by the consultation- liaison psychiatry service in Qatar. Qatar Med J 2021;: 65:http://dx.doi.org/10.5339/qmj.2021.65.
    [Google Scholar]
  7. S. R. Beach, N.C. Praschan, C. Hogan, S. Dotson, F. Merideth, N. Kontos, et al. Delirium in COVID-19: a case series and exploration of potential mechanisms for central nervous system involvement. Gen Hosp Psychiatry 2020;: 65:47-53. doi: 10.1016/j.genhosppsych.2020.05.008. Epub 2020 May 22. PMID: 32470824; PMCID: PMC7242189.
    [Google Scholar]
  8. Z. Wu & J.M. McGoogan. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020; 323:(13): 1239–1242.
    [Google Scholar]
  9. W. A. Alkeridy, I. Almaghlouth, R. Alrashed, K. Alayed, K. Binkhamis, A. Alsharidi, et al. A unique presentation of delirium in a patient with otherwise asymptomatic COVID-19. J Am Geriatr Soc. 2020; 68:(7): 1382-1384. https://doi.org/10.1111/jgs.16536.
    [Google Scholar]
  10. S-C. Shao, C-C. Lai, Y-H. Chen, Y-C. Chen, M-J Hung, S-C Liao. Prevalence, incidence and mortality of delirium in patients with COVID-19: a systematic review and meta-analysis, Age and Ageing, 2021;: 50:1445–1453. https://doi.org/10.1093/ageing/afab103.
    [Google Scholar]
  11. M. Kennedy, B.K.I. Helfand, R.Y. Gou, S.L. Gartaganis, M. Webb, J.M. Moccia, et al. Delirium in older patients with COVID-19 presenting to the emergency department. JAMA Netw Open. 2020; 3:(11):e2029540. doi: 10.1001/jamanetworkopen.2020.29540.
    [Google Scholar]
  12. F. B. Garcez, M.J. Aliberti, P.C. Poco, M. Hiratsuka, S.D. Takahashi, V.A. Coelho, D.B. Salotto, et al. Delirium and adverse outcomes in hospitalized patients with COVID-19. J Am Geriatr Soc 2020; 68:(11): 2440–2446. doi: 10.1111/jgs.16803. Epub 2020 Sep 5. PMID: 32835425; PMCID: PMC7460960.
    [Google Scholar]
  13. N. Alwahaibi, M. Al Maskari, B. Al Dhahli, H. Al Issaei and S. Al Bahlani. One-year review of COVID-19 in the Arab World. Qatar Med J 2021; 2021:(3). https://doi.org/10.5339/qmj.2021.66.
    [Google Scholar]
  14. Y. Iqbal, M.A. Al Abdulla, S. Albrahim, J. Latoo, R. Kumar & P.M. Haddad. Psychiatric presentation of patients with acute SARS-CoV-2 infection: a retrospective review of 50 consecutive patients seen by a consultation-liaison psychiatry team. BJPsych Open. Cambridge University Press 2020; 6:(5): e109.
    [Google Scholar]
  15. J. Helms, S. Kremer, H. Merdji, M. Schenck, F. Severac, R. Clere-Jehl et al. Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patients. Crit Care BioMed Central. 2020;: 24:1–11.
    [Google Scholar]
  16. G. Bellelli, J.S. Brathwaite & P. Mazzola. Delirium: a marker of vulnerability in older people. Front Aging Neurosci. 2021;: 13:626127. doi: 10.3389/fnagi.2021.626127. PMID: 33994990; PMCID: PMC8119654.
    [Google Scholar]
  17. Qatar Demographic Profile, Index Mundi, accessed 19/5/20201. https://www.indexmundi.com/qatar/demographics_profile.html.
  18. T. E. Poloni, A.F. Carlos, M. Cairati, C. Cutaia, V. Medici, E. Marelli, et al: Prevalence and prognostic value of delirium as the initial presentation of COVID-19 in the elderly with dementia: an Italian retrospective study. EClinical-Medicine 2020;: 26:100490. doi: 10.1016/j.eclinm.2020.100490. PMCID: PMC7392565, PMID: 32838241.
    [Google Scholar]
  19. J. S. Generoso, J.L. Barichello de Quevedo, M. Cattani, B.F. Lodetti, L. Sousa, A. Collodel, et al. Neurobiology of COVID-19: how can the virus affect the brain? Braz J Psychiatry 2021; 43:(6): 650–664. doi: 10.1590/1516-4446-2020-1488. PMID: 33605367; PMCID: PMC8639021.
    [Google Scholar]
  20. A. Oussalah, S. Gleye, I.C. Urmes, E. Laugel, F. Barbé, S. Orlowski, et al. The spectrum of biochemical alterations associated with organ dysfunction and inflammatory status and their association with disease outcomes in severe COVID-19: a longitudinal cohort and time-series design study. EClinicalMedicine. Elsevier. 2020;: 27:100554. doi: 10.1016/j.eclinm.2020.100554. Epub 2020 Sep 20. PMID: 32984786; PMCID: PMC7502281.
    [Google Scholar]
  21. Y. R. Guo, Q.D. Cao, Z.S. Hong, T. Yuan-Yang, C. Shou-Deng, J. Hong-Jun, et al. The origin, transmission and clinical therapies on coronavirus disease 2019 (COVID-19) outbreak–an update on the status. Mil Med Res 2020; 7:(1): 1–10. https://doi.org/10.1186/s40779-020-00240-0.
    [Google Scholar]
  22. O. Semyachkina-Glushkovskaya, A. Mamedova, V. Vinnik, M. Klimova, E. Saranceva, V. Ageev, et al. Brain mechanisms of COVID-19-sleep disorders. Int J Mol Sci 2021; 22:(13):6917. doi: 10.3390/ijms22136917. PMID: 34203143; PMCID: PMC8268116.
    [Google Scholar]
  23. T. I. Hariyanto, C. Putri, J.E. Hananto, J. Arisa, V. Fransisca, R. Situmeang, & A. Kurniawan. Delirium is a good predictor for poor outcomes from coronavirus disease 2019 (COVID-19) pneumonia: a systematic review, meta-analysis, and meta-regression. J Psychiatr Res 2021;: 142:361–368. doi: 10.1016/j.jpsychires.2021.08.031.
    [Google Scholar]
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  • Article Type: Short Communication
Keyword(s): consultation–liaison psychiatryCOVID-19deliriumhypoxiainflammatory markersmortality and SARS-Cov2
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