Developing a guidance resource for managing delirium in patients with COVID-19

Meagher, David; Adamis, Dimitrios; Timmons, Suzanne; O’Regan, N; O’Keeffe, Shaun T.; Kennelly, Sean; Corby, C S; Meaney, Anna Maria; Mohamad, M. M.; Glynn, Kevin; O’Sullivan, Róisín

doi:10.1017/ipm.2020.71

Cited by 7 publications

(9 citation statements)

References 21 publications

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“…However, the bulk of our consults were done via phone conversations with patients and staff, as the provision of other electronic gadgets needed to implement more advanced forms of telepsychiatry were not approved. Alternatively, our experience of delirium mirrors that reported globally ( Beach et al, 2020 ; Meagher et al, 2020 ). Another challenge faced is the resistance from medical teams in initiating antipsychotics for agitated delirium.…”

Section: Country-specific Insightssupporting

confidence: 79%

Management of psychiatric conditions and delirium during the COVID-19 pandemic across continents: lessons learned and recommendations

Ojeahere

Filippis

Ransing

et al. 2020

Brain, Behavior, & Immunity - Health

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Background With the uncertainties of COVID-19, people infected by coronavirus present with diverse psychiatric presentations. Some centers have had to manage their patients with existing protocols, others have had to come up with innovations. We aim to report the challenges and good practices recorded in the management of psychiatric conditions and delirium coexisting with COVID-19 and during the COVID-19 era across continents. Material and Methods Early Career Psychiatrists (ECPs) from across five continents were approached to provide their perspective on the management of psychiatric conditions in patients with COVID-19 and during the current pandemic. Results We collected information about the experiences from ten countries. Commonalities were similar psychiatric presentations and poor preparedness across countries. Differences were varying innovations and adjustments made in the management of psychiatric conditions coexisting with COVID-19. Good practices which can be adopted by other countries are novel approaches such as telepsychiatry, proactive consultation-liaison units and enhanced community services targeted at circumventing challenges faced yet providing mental health services. Conclusions This publication highlights the need for global preparedness in the mental health sector during outbreaks of infectious diseases. With our results we can conclude that there is the need for concerted efforts targeted at global and locally sensitive adaptation of existing protocols and the development of new guidelines for the management of psychiatric conditions for the present pandemic and subsequent occurrences.

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Section: Country-specific Insightssupporting

confidence: 79%

Management of psychiatric conditions and delirium during the COVID-19 pandemic across continents: lessons learned and recommendations

Ojeahere

Filippis

Ransing

et al. 2020

Brain, Behavior, & Immunity - Health

View full text Add to dashboard Cite

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“…Moreover, the presence of pain should be assessed and treated if necessary. Furthermore, drug prescription should be optimizing with particular attention to the anticholinergic burden [42].…”

Section: Delirium In Covid-19 Patients With Dementiamentioning

confidence: 99%

Dementia Clinical Care in Relation to COVID-19

Bianchetti

Rozzini

Bianchetti³

et al. 2022

Curr Treat Options Neurol

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Purpose of Review This review discusses the complex relationship between COVID-19 and dementia and how the pandemic has affected the management of patients with dementia. This population resulted particularly susceptible to SARS-CoV-2 infection and its effects and also to the negative effects of the measures taken worldwide to control the spread of the virus. Recent Findings Patients with dementia were at increased risk for COVID-19 compared to patients without dementia, and diagnosis of dementia represents an independent risk factor for hospitalization in COVID-19 patients. Mortality due to SARS-CoV2 infection in subjects with dementia is 2–5 times higher than in the general population. Cognitive impairment and delirium have been described in COVID-19 survivors. SARS-COV2 pandemic exacerbates the vulnerability of dementia patients and their caregivers, due to the morbidity and mortality from COVID-19, the indirect effects of the pandemic on the social supports, and the effects on healthcare system on which they depend. Summary The COVID-19 pandemic requires people with dementia to move from traditional models of health care to innovative models for home care, to support caregivers’ burden, and to improve long term care.

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“…Current recommendations state that drug treatment should only be started in patients with delirium who present agitation, aggression, paranoia, hallucinations, and/or when, in addition, these symptoms pose a risk of imminent harm to the patient or their caregiver (Meagher et al, 2020). For the choice of the antipsychotic agent, the desired clinical effect, pharmacokinetic, and pharmacodynamic profile, as well as…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Prevention, diagnosis, and treatment of delirium in older adults with COVID-19. Literature review

et al. 2020

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Background. COVID-19 affects several systems in the body, including the central nervous system (CNS), expressed in the form of headaches, hyposmia, cerebrovascular disease, and neuropathy. Older Adults (OA) are vulnerable to this infection, and may also present delirium, which may be the result of the virus directly affecting the CNS or of systemic inflammation during infection. Objective. To determine the clinical characteristics, risk factors, pathophysiology, treatment measures, and prevention of delirium associated with COVID-19 from a review of the literature in times of the SARS-CoV-2 pandemic. Method. A search was conducted in PubMed, SciELO, UpToDate, and Medscape using keywords in English and Spanish. Results. Seventy-two articles were reviewed. We analyzed inclusion and exclusion criteria and 43 articles with relevant information for the narrative description of the review were selected. Twenty to thirty per cent of the COVID-19 patients will present or develop delirium, or changes in mental status during their hospitalization, with rates of 60% to 70% in severe illness. The exact mechanisms are likely to be multifactorial. There is a worrying lack of attention to the implications of identifying and managing delirium in the response to this pandemic. Discussion and conclusion. Delirium is a frequent neurological manifestation in OA with COVID-19 and requires early identification, as well as the implementation of non-pharmacological and pharmacological treatment strategies, which may reduce the associated morbidity and mortality in this age group.

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Developing a guidance resource for managing delirium in patients with COVID-19

Cited by 7 publications

References 21 publications

Management of psychiatric conditions and delirium during the COVID-19 pandemic across continents: lessons learned and recommendations

Management of psychiatric conditions and delirium during the COVID-19 pandemic across continents: lessons learned and recommendations

Dementia Clinical Care in Relation to COVID-19

Prevention, diagnosis, and treatment of delirium in older adults with COVID-19. Literature review

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