A longer look at COVID-19 and neuropsychiatric outcomes

Rogers, Jonathan; David, Anthony S.

doi:10.1016/s2215-0366(21)00120-6

Cited by 22 publications

(23 citation statements)

References 11 publications

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“…However, newly diagnosed psychotic disorders were more common in older patients, patients hospitalized for COVID-19 and those with encephalopathy [ 1 ]. Some have hypothesized that, in addition to emergence of a new clinical entity, this association might represent diagnostic confusion between psychotic disorders and delirium, since delirium was likely underreported in this study [ 12 ] and since psychotic disorders are often misdiagnosed in cases of delirium [ 13 , 14 ]. New diagnoses of psychosis might also represent emergence of undocumented mental illness, as electronic health records are limited in their ability to capture mental health diagnoses [ 15 ] and patients with psychotic disorders are at increased risk for COVID-19 infection [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

COVID-19-associated psychosis: A systematic review of case reports

Smith

Gilbert

Riordan

et al. 2021

General Hospital Psychiatry

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Objectives To describe the comorbidities, presentations, and outcomes of adults with incident psychosis and a history of COVID-19. Methods We completed a descriptive systematic review of case reports according to PRISMA guidelines, including cases of adult patients with incident psychosis and antecedent or concurrent COVID-19. We extracted patient demographics, comorbidities, clinical course, and outcomes, and assessed cases for quality using a standardized tool. Results Of 2396 articles, we included 40 reports from 17 countries, comprising 48 patients. The mean age of patients was 43.9 years and 29 (60%) were males. A total of 7 (15%) had a documented psychiatric history, 6 (13%) had a substance use history and 11 (23%) had a comorbid medical condition. Delusions were the most common (44 [92%]) psychiatric sign and psychosis lasted between 2 and 90 days. A total of 33 (69%) patients required hospitalization to a medical service and 16 (33%) required inpatient psychiatric admission. The majority (26 [54%]) of cases did not assess for delirium and 15 (31%) cases were judged to be of high risk of bias. Conclusions Despite the growing awareness of COVID-19's association with incident psychosis at a population level, cases of COVID-19-associated psychosis often lacked clinically relevant details and delirium was frequently not excluded. PROSPERO registration number: CRD42021256746.

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Section: Introductionmentioning

confidence: 99%

COVID-19-associated psychosis: A systematic review of case reports

Smith

Gilbert

Riordan

et al. 2021

General Hospital Psychiatry

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“…During the current pandemic, concerns were raised early on that this could happen with COVID-19. 17 Recently, a large retrospective database study followed 236 379 patients for 6 months after a COVID-19 diagnosis and compared symptoms against patients who had influenza or a respiratory tract infection during the same period. 18 They reported that the presence of COVID-19 was significantly associated with neurological and psychiatric symptoms with an estimated incidence of 33.62% at 6 months.…”

Section: Discussionmentioning

confidence: 99%

Symptom Cluster Analysis of long COVID-19 in Patients Discharged from the Temporary COVID-19 Hospital in Mexico City: A Longitudinal Study

Rm¹,

Exr²,

Car³

et al. 2021

Preprint

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Recently, several reports have emerged describing the long-term consequences of COVID-19 that may affect multiple systems, suggesting its chronicity. As further research is needed, we conducted a longitudinal observational study to report the prevalence and associated risk factors of long-term health consequences of COVID-19 by symptom clusters in patients discharged from the Temporary COVID-19 Hospital (TCH) in Mexico City. Self-reported clinical symptom data were collected via telephone calls over 90 days post-discharge. Among 4670 patients discharged from the TCH, we identified 45 symptoms across eight symptom clusters (neurological; mood disorders; systemic; respiratory; musculoskeletal; ear, nose, and throat; dermatological; and gastrointestinal). We observed that the neurological, dermatological, and mood disorder symptom clusters persisted in >30% of patients at 90 days post-discharge. Although most symptoms decreased in frequency between day 30 and 90, alopecia and the dermatological symptom cluster significantly increased (p<0·00001). Women were more prone than men to develop long-term symptoms and invasive mechanical ventilation also increased the frequency of symptoms at 30-days post-discharge. Overall, we observed that symptoms often persisted regardless of disease severity. We hope these findings will help promote public health strategies that ensure equity in the access to solutions focused on the long-term consequences of COVID-19.

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“…The PHQ-9 (range, 0-27) was used to assess depression symptoms with the total scores categorized as follows: controls (0-4), mild (5-9), moderate (10)(11)(12)(13)(14), and severe (15-27) (35). The GAD-7 (range, 0-21) was used to assess anxiety symptoms with the total scores categorized as follows: controls (0-4), mild (5)(6)(7)(8)(9), moderate (10)(11)(12)(13)(14), and severe (15-21) (36). The IES-R (range, 0-88) was used to assess subjective distress (excessive panic and anxiety) caused by traumatic events including traumarelated distressing memories and persistent negative emotions resulting from the pandemic, which is composed of three subscales to measure the avoidance, intrusion, and hyper-arousal.…”

Section: Assessment Of Mental Healthmentioning

confidence: 99%

“…There are many reports of increased prevalence and severity of mental health problems including those of depression, anxiety, and distress during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic in the general population, medical health care workers (1)(2)(3)(4)(5)(6)(7)(8)(9), and persons with chronic diseases (10,11). Several studies reported that cancer patients experienced mental health problems or worse healthrelated quality of life (HRQoL) (12)(13)(14)(15)(16)(17)(18)(19)(20)(21), which were associated with delay in cancer care or reduced therapy intensity.…”

Section: Introductionmentioning

confidence: 99%

Mental Health in Persons With Chronic Myeloid Leukemia During the SARS-CoV-2 Pandemic: The Need for Increased Access to Health Care Services

et al. 2021

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Mental health problems in the general population have been reported during the SARS-CoV-2 pandemic; however, there were rare data in persons with chronic myeloid leukemia (CML). Therefore, we performed a cross-sectional study on mental health evaluated using the 9-item Patient Health Questionnaire (PHQ-9; depression), the 7-item Generalized Anxiety Disorder (GAD-7; anxiety), and the 22-item Impact of Event Scale—Revised (IES-R; distress), including subscales of avoidance, intrusion, and hyper-arousal in persons with CML, non-cancer persons, and immediate family members of persons with cancer as controls (≥16 years) by an online survey. Data from 3,197 persons with CML and 7,256 controls were collected. In multivariate analyses, CML was significantly associated with moderate to severe depression (OR = 1.6; 95% Confidence Interval [CI], 1.4, 1.9; p < 0.001), anxiety (OR = 1.4 [1.1, 1.7]; p = 0.001), distress (OR = 1.3 [1.1, 1.5]; p < 0.001), and hyper-arousal (OR = 1.5 [1.3, 1.6]; p < 0.001). Moreover, delay in regular monitoring was significantly associated with depression (OR 1.3 [1.0, 1.7]; p = 0.024), anxiety (OR = 1.3 [1.0, 1.8]; p = 0.044), avoidance (OR = 1.2 [1.0, 1.4]; p = 0.017), and intrusion (OR = 1.2 [1.0, 1.4]; p = 0.057); tyrosine kinase-inhibitor dose reduction or discontinuation, depression (OR = 1.9 [1.3, 2.8]; p = 0.001), distress (OR = 2.0 [1.4, 2.8]; p < 0.001), avoidance (OR = 1.6 [1.2, 2.1]; p = 0.004), intrusion (OR = 1.6 [1.1, 2.1]; p = 0.006), and hyper-arousal (OR = 1.3 [1.0, 1.8]; p = 0.088). We concluded that persons with CML during the SARS-CoV-2 pandemic have worse mental health including depression, anxiety, and distress symptoms. Decreasing or stopping monitoring or dose resulted in adverse mental health consequences.

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A longer look at COVID-19 and neuropsychiatric outcomes

Cited by 22 publications

References 11 publications

COVID-19-associated psychosis: A systematic review of case reports

COVID-19-associated psychosis: A systematic review of case reports

Symptom Cluster Analysis of long COVID-19 in Patients Discharged from the Temporary COVID-19 Hospital in Mexico City: A Longitudinal Study

Mental Health in Persons With Chronic Myeloid Leukemia During the SARS-CoV-2 Pandemic: The Need for Increased Access to Health Care Services

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