ABSTRACT
BACKGROUND: The purpose is to study the structure of clinical manifestations of mental disorders in the acute period of COVID-19 among patients, who were hospitalized with a new coronavirus infection and their relations with the severity of the immune response, to assess the efficacy and safety profile of the spectrum of used psychopharmacotherapy. MATERIAL AND METHODS: A study was conducted of patients, hospitalized to the department of infectious diseases and repurposed for COVID-19 clinical departments with a diagnosis of COVID-19 (compliance with the criteria for ICD-10: U07.1) from September 2020 to March 2021. Study design: single center opened retrospective cohort study. The main group is consisted of 72 patients, average age - 71 [56.0; 81.0] years, the part of women - 64.0%. The control group (n=2221) was formed from those hospitalized in the same period with a diagnosis of U07.1 without mental disorders during the hospitalization period, average age 62 [51.0; 72.0] years, the part of women - 48.7%. Mental disorders were diagnosed in accordance to ICD-10 criteria, the following peripheral markers of inflammation, that were evaluated: neutrophils, lymphocytes, platelets, ESR, C-reactive protein, interleukin; also coagulogram indicators: APTT, fibrinogen, prothrombin time, D-dimers. RESULTS: In the following range of mental disorders were identified: a depressive episode (ICD-10 F32) by 31 patients, by 22 - a disorder of adaptive reactions (ICD-10 F43.2), by 5 - delirium not caused by alcohol or other psychoactive substances (ICD-10 F05), by 14 - mild cognitive impairment caused by damage and disfunction of the brain or somatic diseases (ICD-10 F06.7). In comparison with the control group, these patients showed a statistically significant (p<0.001) increasing the level of inflammatory markers (CRP, IL-6) and changes in the coagulogram. and anxiolytic drugs were used most often. Regarding psychopharmacotherapy, drugs from the group of atypical antipsychotics - quetiapine was prescribed in 44% patients in average dose 62.5 mg per day, and Melatonin receptor type 1 and 2 agonist and antagonists of serotonin 5-HT2C receptors: agomelatine was prescribed in 11% patients in average dose 25 mg per gay. CONCLUSION: The results of the study confirm the heterogeneity of the structure of mental disorders in the acute form of coronavirus infection, revealing the relations between the clinical picture and laboratory parameters of the immune response to systemic inflammation. Recommendations are given for the choice of psychopharmacotherapy, in conformity with the peculiarities of pharmacokinetics and interaction with somatotropic therapy.
Subject(s)
Antipsychotic Agents , COVID-19 , Mental Disorders , Humans , Female , Aged , Middle Aged , COVID-19/complications , Retrospective Studies , InflammationABSTRACT
Introduction: COVID-19 affects nervous system and the mental health of patients. Objective(s): The aim of the study was to determine the prevalence of depression, anxiety, and insomnia among patients hospitalized with COVID-19 in order to understand mediating factors and inform tailored intervention. Method(s): To the study patients with mild and moderate COVID -19 were included. It was no included patients with diagnosed psychiatric disorders. It was conducted an interview, including using telemedicine technologies, assessed HADS, MFI-20, Pittsburgh Sleep Quality Index (PSQI) questionnaire. Result(s): It was analyzed the data of 119 patients, 34% patients was female, mean age 58,7+/-11,1 range 47 to 69 years. Anxietydepressive symptoms were observed in 33/119 (28%) patients by HADS scale. Clinically significant anxiety and depression were seen in 11% and 4% of the patients, respectively. In 13% patients was observed as anxiety as depression. An increase in the MFI-20 scale (more than 20 points) was found in 87 (73.0%) patients, sleep disorders in accordance with the PSQI questionnaire was recorded in 32 (27.0%) patients. Sleep disorders were manifested by dissatisfaction with sleep quantity or quality that is associated with difficulty falling asleep. All patients have asthenic symptom. Conclusion(s): It was noted that in most patients with COVID-19, along with a depressive and anxiety disorders, an asthenic symptom complex, sleep disturbances are recorded. The choice of the medical intervention should be based on the severity of the violations identified taking into account the side effects of the prescribed drugs, drug interactions and somatic status of patients.
ABSTRACT
Objectives. To study the prevalence of anxious-depressive disorders and sleep impairments in their structure among patients hospitalized with the new coronavirus infections (COVID-19) and to develop differential guidelines for their treatment in COVID-19 patients. Materials and methods. This report presents preliminary results from our own observations. We report here analysis of data from 119 patients (age 47–69 years, male and female) obtained at detailed interviews, including using telemedicine technologies, with evaluation on the following scales: the Hospital Anxiety and Depression Scale (HADS), the Multidimensional Fatigue Inventory (MFI-20) for subjective assessment of asthenia, and the Pittsburgh Sleep Quality Index (PSQI). Results. Results on the HADS indicated that clinically severe anxious-depressive symptomatology was seen in 33 of 119 patients (28%) hospitalized with diagnoses of COVID-19: of these, 11% of cases (n = 13) showed clinical signs of significant anxiety only, while five (4%) showed clinically significant depression and 13% displayed increases on both the anxiety and depression subscales (n = 15). Increases on the MFI-20 scale (>20 points) were seen in 87 patients (73%) and sleep impairments on the PSQI were recorded in 32 patients (27%). Conclusions. The results of this study showed that most patients with COVID-19 had not only depressive symptomatology, but also anxious and hypochondriac disorders, asthenic symptom complex, and sleep impairments with difficulty going to sleep and poor sleep quality. Differential guidelines were developed for the treatment of these states taking account of the side effects of the drugs prescribed, interactions between drugs, and the features of the patients’ somatic condition. Drug selection must be based on the severity of the impairments found.
ABSTRACT
PURPOSE OF THE STUDY: To study the prevalence of anxiety-depressive disorders and sleep disorders in their structure among patients hospitalized in connection with COVID-19, as well as to develop differentiated recommendations for their therapy in patients with new coronavirus infection. MATERIAL AND METHODS: In this publication, the authors present preliminary results of their own observations of psychoemotional disorders and sleep disorders in their structure in patients with a new coronavirus infection. We analyzed the data of 119 patients (aged 47 to 69 years, male and female), conducted a detailed interview, including using telemedicine technologies, and assessed the scales: The hospital Anxiety and Depression Scale (HADS), subjective the asthenia rating scale (MFI-20, Multidimensional Fatigue Inventory) and the Pittsburgh Sleep Quality Index (PSQI) questionnaire. RESULTS: According to the results of the HADS questionnaire, clinically pronounced anxiety-depressive symptoms were observed in 33 (28%) patients of 119 hospitalized in connection with the diagnosis of COVID-19. Of them, only clinically significant anxiety was recorded in 11% of cases (n=13), in 5 (4%) patients - clinically significant depression, an increase in both subscales of anxiety and depression - in 13% (n=15). An increase in the MFI-20 scale (more than 20 points) was found in 87 (73%) patients, sleep disorders in accordance with the PSQI questionnaire was recorded in 32 (27%) patients. CONCLUSION: According to the results of the study, it was noted that in most patients with COVID-19, along with a depressive symptom complex, anxiety and hypochondriacal disorders, an asthenic symptom complex, sleep disturbances with difficulty falling asleep, and dissatisfaction with the quality of sleep are recorded. Differentiated recommendations for the treatment of the studied conditions have been developed, taking into account the side effects of the prescribed drugs, drug interactions and the characteristics of the somatic status of patients. The choice of the drug should be based on the severity of the violations identified.