A severe COVID-19 case with schizophrenia as well as other chronic diseases

Zeng, Lizhu; Zhang, Huagen; He, Yongjun; Lai, Bifa; Huang, Zhen; Zhong, Zhixiong; Guo, Xuemin

doi:10.1590/1414-431x202010426

Cited by 4 publications

(1 citation statement)

References 12 publications

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“…Psychiatric disorders reported that for the management of anxiety and agitation in COVID-19 patients, the following drugs have been recommended and used successfully: in patients over 18 years of age with swallowing ability lorazepam 0.5–1 mg orally four times a day (maximum 4 mg in 24 h) [ 157 , 158 ], in elderly or debilitated patients the dose should be reduced to 0.25–0.5 mg (maximum 2 mg in 24 h); for anxiety or agitation with inability to swallow it is recommended to use midazolam 2.5–5 mg every 2–4 h as needed, and if frequently needed an infusion of 10 mg over 24 h. For delirium manifestations in patients with swallowing capacity, it is recommended to use 0.5–1 mg of haloperidol at night and every 2 h when needed (maximum 10 mg daily, or 5 mg daily in elderly patients) and this can be administered subcutaneously; a higher initial oral dose is recommended (1.5–3 mg) if the patient is very distressed or is causing immediate danger to others, as well as the addition of benzodiazepines such as lorazepam or midazolam [ 158 ] if the patient remains agitated. Olanzapine (10 mg per day) has also been successfully used in the treatment of severe COVID-19 and schizophrenia (tension, panic, anxiety, aggression, and paranoia); midazolam, diazepam, and dexmedetomidine were administered to relieve anxiety and aid sleep [ 158 , 159 ]. In addition, agomelatine use (36 mg/day and 72 mg/day orally in four doses) has been reported to improve the capacity for sleep [ 160 ].…”

Section: Pharmacological Treatment For Patients With Neurological or Psychiatric Manifestations Associated With Covid-19mentioning

confidence: 99%

Use of Antioxidants for the Neuro-Therapeutic Management of COVID-19

et al. 2021

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Coronavirus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is an emergent infectious disease that has caused millions of deaths throughout the world. COVID-19 infection’s main symptoms are fever, cough, fatigue, and neurological manifestations such as headache, myalgias, anosmia, ageusia, impaired consciousness, seizures, and even neuromuscular junctions’ disorders. In addition, it is known that this disease causes a series of systemic complications such as adverse respiratory distress syndrome, cardiac injury, acute kidney injury, and liver dysfunction. Due to the neurological symptoms associated with COVID-19, damage in the central nervous system has been suggested as well as the neuroinvasive potential of SARS-CoV-2. It is known that CoV infections are associated with an inflammation process related to the imbalance of the antioxidant system; cellular changes caused by oxidative stress contribute to brain tissue damage. Although anti-COVID-19 vaccines are under development, there is no specific treatment for COVID-19 and its clinical manifestations and complications; only supportive treatments with immunomodulators, anti-vascular endothelial growth factors, modulating drugs, statins, or nutritional supplements have been used. In the present work, we analyzed the potential of antioxidants as adjuvants for the treatment of COVID-19 and specifically their possible role in preventing or decreasing the neurological manifestations and neurological complications present in the disease.

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Section: Pharmacological Treatment For Patients With Neurological or Psychiatric Manifestations Associated With Covid-19mentioning

confidence: 99%

Use of Antioxidants for the Neuro-Therapeutic Management of COVID-19

et al. 2021

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Multiple drugs

2021

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Multiple drugs Various toxicities: case report A man in his late 50s [exact age at reactions onset not stated] developed liver damage during treatment with albumin human, amlodipine, chloroquine, cobicistat/darunavir, dexmedetomidine, diazepam, fluconazole, furosemide, heparin, immune globulin, insulin, lopinavir/ritonavir, methylprednisolone, metformin, metoprolol, midazolam, nifedipine, olanzapine, piperacillin/ tazobactam, quetiapine, risperidone, thymalfasin and umifenovir. In addition, he experienced anxiety, depression and insomnia as manifestations of a poor mental state during treatment with quetiapine and risperidone. Further, he received off-label treatment with chloroquine, cobicistat/darunavir, immune globulin, lopinavir/ritonavir, thymalfasin and umifenovir for COVID-19 [not all routes stated; dosages not stated]. The man developed a fever on 25 January 2020, accompanied by a mild cough, chills and shortness of breath. Since the fever persisted, he was hospitalised in China on 1 February 2020. A review of his medical records revealed that he had hypertension (for which he was receiving metoprolol and nifedipine tablets daily, along with [amlodipine] amlodipine besylate tablets), type 2 diabetes (for which he was receiving metformin tablets daily) and schizophrenia (for which he was receiving risperidone and quetiapine [quetiapine fumarate] tablets daily). He stated that the control of his chronic diseases was acceptable; however, his mental state was poor, manifesting as anxiety, depression and insomnia. Physical examination revealed obvious schizophrenic symptoms. Following further analyses, he was diagnosed with COVID-19. He received oxygen via nasal catheter to increase oxygen saturation, and methylprednisolone to attenuate lung inflammation, alongside unspecified supportive psychotherapy. He also received antivirals (lopinavir/ritonavir [lopinavir and ritonavir] tablets), anti-schizophrenic drugs (quetiapine and risperidone tablets), antihypertensive agents (metoprolol and nifedipine sustained-release, SR tablets), antidiabetic agents (metformin SR tablets and insulin injection), and immunomodulators (IV immune globulin and thymalfasin injection). On the evening of 3 February 2020 (2 days post admission), his condition deteriorated. He was shifted to a negative pressure ward, after non-invasive ventilation rescue with ECG monitoring. In the meantime, he developed multiple complications, including type-II respiratory failure, sequelae of cerebral infarction, acute respiratory distress syndrome, electrolyte metabolism disorders and hyperlactic acidaemia, leading to a severe case of COVID-19. In order to improve the man's compliance to the treatment, quetiapine and risperidone were discontinued and replaced with olanzapine tablets, to minimise the side effects of headache, insomnia and anxiety. In addition, he received diazepam, midazolam injection and dexmedetomidine injection to ease anxiety and aid sleep. The supportive psychotherapy was strengthened; umifenovir [arbidol] and fluconazole capsules...

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Probing the Neuro-psychological Changes Observed with the Administration of COVID-19 Drugs

Chatterjee

Bansal

2023

CTMC

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Background: The COVID-19 virus caused countless significant alterations in the human race, the most challenging of which was respiratory and neurological disorders. Several studies were conducted to find a robust therapy for the virus, which led to a slew of additional health issues. Objective: This study aims to understand the changes in the neurological system brought about by COVID-19 drugs and highlights the drug-drug interaction between COVID-19 drugs and psychiatric drugs. Alongside this, the study focuses on the neuropsychological changes in three critical mental disorders, such as schizophrenia, Alzheimer’s disease, and Parkinson’s disease. Methods: The comprehensive and narrative review being performed in this paper, has brought together the relevant work done on the association of COVID-19 drugs and changes in the neurological system. For this study, a systematic search was performed on several databases such as PubMed, Scopus, and Web of Science. This study also consolidates shreds of evidence about the challenges confronted by patients having disorders like Schizophrenia, Alzheimer’s disease, and Parkinson's disease. This review is based on the studies done on COVID-19 drugs from mid-2020 to date. Conclusion: We have identified some scopes of crucial future opportunities which could add more depth to the current knowledge on the association of COVID-19 drugs and the changes in the neurological system. This study may present scope for future work to investigate the pathophysiological changes of these disorders due to COVID-19.

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A severe COVID-19 case with schizophrenia as well as other chronic diseases

Cited by 4 publications

References 12 publications

Use of Antioxidants for the Neuro-Therapeutic Management of COVID-19

Use of Antioxidants for the Neuro-Therapeutic Management of COVID-19

Multiple drugs

Probing the Neuro-psychological Changes Observed with the Administration of COVID-19 Drugs

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