Delirium and other neuropsychiatric manifestations of COVID-19 infection in people with preexisting psychiatric disorders: a systematic review

Reekum, Emma A van; Rosic, Tea; Sergeant, Anjali; Sanger, Nitika; Rodrigues, Myanca; Rebinsky, Reid; Panesar, Balpreet; Deck, Eve; Kim, Nayeon; Woo, Julia; D’Elia, Alessia; Hillmer, Alannah; Dufort, Alexander; Sanger, Stephanie; Thabane, Lehana; Mbuagbaw, Lawrence; Samaan, Zainab

doi:10.1186/s13256-021-03140-6

Cited by 7 publications

(5 citation statements)

References 64 publications

(116 reference statements)

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“…Even though individuals with pre-existing psychiatric disorders appear to have a major risk of developing delirium (80), among the patients described herein, 1 patient had a history of psychiatric disorders. Age-related dementia was present in the majority of patients in the present study.…”

Section: Discussionmentioning

confidence: 83%

Delirium during COVID‑19: A report of eight cases and a review of the literature

et al. 2022

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Delirium is an acute confusional state, often associated with long-term hospitalization, oxygen supplementation, the male sex and an older age. Since the start of the coronavirus disease 2019 (COVID-19) pandemic, there was an abrupt increase in intensive care unit (ICU) admissions and hospitalization in general, as well as in the need for oxygen therapy and enforced isolation due to the contagion risk. This caused a sudden increase in the episodes of delirium. The diagnosis of delirium, however, remains a difficult task, as it can often be misdiagnosed or confused with underlying dementia, particularly among the elderly. The present study describes present eight cases of patients admitted to hospital due to severe acute respiratory syndrome coronavirus 2 infection, who manifested delirium. Notably, only one of the patients had psychiatric comorbidities prior to hospitalization. The most prevalent sex was the male (7:1) one, the mean age of the patients was 81.7±4 years, and the mean duration of hospitalization was 23.6±6 days. In total, 3 patients had a virological recovery and were discharged, 3 had a clinical recovery and were transferred to a lower intensity COVID-19 facility and 2 patients did not survive. In the eight cases described herein, the mortality rate was 25%. Delirium was found to be commonly associated with a higher mortality rate and a longer hospitalization period. Therefore, it is imperative to develop protocols and tools with which to rapidly assess delirium and treat it accordingly. In addition, it is fundamental to improve the quality of life of hospitalized patients, supporting behavioral therapy and the environmental factors that can affect patients, to prevent delirium as well.

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Section: Discussionmentioning

confidence: 83%

Delirium during COVID‑19: A report of eight cases and a review of the literature

et al. 2022

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“…In our case, patient X presented with gastrointestinal (GI) symptoms leading to delirium. Generally, GI and respiratory symptoms are common triggers before the acute confusion state [ 16 ]. The SARS-CoV-2 virus entry in the host cells is mediated through the angiotensin-converting enzyme-2 (ACE-2) receptor.…”

Section: Discussionmentioning

confidence: 99%

Delirium in a Relatively Young Person due to COVID-19 Infection

Das

Melgar

Rasool

et al. 2023

Case Reports in Psychiatry

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The coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2 virus), has significantly impacted global health. It can present a range of complications, from asymptomatic to severe respiratory distress syndrome. It has also been linked to complications in multiple organ systems, including neurological symptoms such as headaches and encephalopathy. Delirium, characterized by acute confusion, is common in older adults and associated with prolonged hospital stays and elevated mortality rates. We present a case study of a young mother with a prior medical history of mild to moderate depression who experienced an episode of delirium consequent to a COVID-19 infection. The initial manifestation of her illness was mild diarrhea, but as her condition worsened, she began exhibiting symptoms of delirium. These symptoms include confusion, agitation, sleep disturbance, and disordered behavior. The delirious episode was brief and effectively managed with small doses of psychotropic medications to control aggressive behavior. Upon resolution, no additional treatment was deemed necessary. This case underscores the wide-ranging effects of COVID-19 on physical and psychological well-being and highlights the importance of considering symptoms beyond those associated with respiratory distress.

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“…We registered our systematic review on PROSPERO (CRD42020179611) and published our protocol 23 . We split our review question into two papers; the first paper on neuropsychiatric outcomes associated with the COVID‐19 pandemic is published elsewhere 24 . We followed Meta‐Analyses of Observational Studies in Epidemiology (MOOSE) 25 reporting guidelines.…”

Section: Methodsmentioning

confidence: 99%

Association between the COVID‐19 pandemic and psychiatric symptoms in people with preexisting obsessive‐compulsive, eating, anxiety, and mood disorders: a systematic review and meta‐analysis of before‐after studies

Reekum

Woo

Petropoulos

et al. 2023

Psychiatry Clin Neurosci

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AimTo determine whether, in people with pre‐existing obsessive‐compulsive, eating, anxiety, and mood disorders, the COVID‐19 pandemic was associated with a change in psychiatric symptoms, compared to pre‐pandemic levels.MethodsWe searched MEDLINE, CINAHL, PsychINFO, and EMBASE from inception until February 16th, 2022. Studies were included if they reported pre‐pandemic and during‐pandemic psychiatric symptoms, using validated scales, in people with pre‐existing mood, anxiety, eating, or obsessive‐compulsive disorders. Two reviewers independently screened studies, extracted data, and assessed evidence certainty. Random‐effects meta‐analyses were conducted. Effect sizes were reported as standardized mean differences (SMD) with 95% confidence intervals (CIs).ResultsEighteen studies, from 10 countries, were included. Of the 4465 included participants, 68% were female and the average age was 43. Mood and obsessive‐compulsive disorders were the most studied disorders. During‐pandemic psychiatric measurements were usually collected during nationwide lockdown. Obsessive‐compulsive symptoms worsened among people with obsessive‐compulsive and related disorders, with a moderate effect size (N = 474 [6 studies], SMD = ‐0.45, 95%CI ‐0.82, −0.08, I2 = 83%; very low certainty). We found a small association between the COVID‐19 pandemic and reduced anxiety symptoms in people with mood, anxiety, obsessive‐compulsive, and eating disorders (N = 3738 [6 studies], SMD = 0.11, 95%CI 0.02, 0.19, I2 = 63%; very low certainty). No change in loneliness, depressive or eating symptoms was found.ConclusionPeople with obsessive‐compulsive and related disorders may benefit from additional monitoring during the COVID‐19 pandemic and possibly future pandemics. Other psychiatric symptoms were stable in people with the specific disorders studied. Overall, evidence certainty was very low.This article is protected by copyright. All rights reserved.

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Delirium and other neuropsychiatric manifestations of COVID-19 infection in people with preexisting psychiatric disorders: a systematic review

Cited by 7 publications

References 64 publications

Delirium during COVID‑19: A report of eight cases and a review of the literature

Delirium during COVID‑19: A report of eight cases and a review of the literature

Delirium in a Relatively Young Person due to COVID-19 Infection

Association between the COVID‐19 pandemic and psychiatric symptoms in people with preexisting obsessive‐compulsive, eating, anxiety, and mood disorders: a systematic review and meta‐analysis of before‐after studies

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