ABSTRACT
OBJECTIVE: To determine the impact of COVID-19 pandemic (COVID-19-P) on clinical and health organisational variables of patients evaluated by Liaison Psychiatry (LP). METHODS: Revision of all collaboration requests (CR) to LP for patients hospitalised in a Portuguese General Hospital during the second wave of COVID-19-P, from 1 October to 31 December of 2020. Medical charts were analysed and selected variables were compared with those of the homologous non-pandemic period. Data were statistically analysed. RESULTS: There was a 22.3% decrease in the number of CR in 2020. The most frequently given reasons for CR were depressive symptoms, psychomotor agitation, and difficulties in adapting to the disease in both years. However, 5.9% more patients reported suicidal ideation in 2020. The hospitalisation length before CR was smaller in 2020 than in 2019 (9 vs 11). There was a higher proportion of patients followed in a psychiatric consultation and previously taking psychotropic medication before hospitalisation in 2020 than in 2019. After the assessment, the trend was that both groups did not meet diagnostic criteria for any disorder and no pharmacological adjustment was needed. CONCLUSION: This study highlights the need to better characterise the indirect repercussion of COVID-19-P, and focus on the prevention and treatment of mental illness particularly in adverse contexts.Key PointsFewer collaboration requests to liaison psychiatry during the second wave of COVID-19;Collaboration requests were made earlier in the hospitalisation;For patients with more medical comorbidities, psychiatric history, and psychotropic medication;Most because of depressive symptoms and more with suicidal ideation;Fewer collaboration requests to liaison psychiatry during COVID-19;Made earlier in the hospitalisation;For patients with more medical comorbidities, psychiatric history, and medication;Most because of depressive symptoms and more with suicidal ideation.
ABSTRACT
INTRODUCTION: The SARS-CoV-2 infection has been associated with the acute onset of mental and behavioural symptoms and psychiatric disorders. The aim of this study was to assess the prevalence of the different neuropsychiatric diagnoses in hospitalized patients with SARS-CoV-2 infection assessed by Liaison Psychiatry. MATERIAL AND METHODS: We performed a cross-sectional study in a hospital near Lisbon, Portugal. We reviewed the electronic health records from all inpatients with a positive SARS-CoV-2 RT-PCR test that were assessed by the Liaison Psychiatry Unit (LPU) between February and December 2020. We reviewed relevant sociodemographic and clinical data, including 15 neuropsychiatric symptoms. The prevalence of psychiatric disorders was our main outcome. We also explored differences between two groups: patients with delirium (delirium group) and patients without delirium (no delirium group). RESULTS: We included 46 cases [Age: median = 67 years; interquartile range (IQR) = 24)], with 60.9% male individuals. Delirium was the most frequent diagnosis in our sample (43.5%), followed by major depressive disorder (21.7%). Patients with delirium were more likely to suffer from COVID-19 symptoms (delirium: 19/20, 95%; no delirium: 14/26, 53.8%; p = 0.02), and to have a longer time interval between a positive SARS-CoV-2 RT-PCR test and an evaluation by the LPU (delirium: median = 16.5 days, IQR = 16; no delirium: median = 8 days, IQR = 16.3; p = 0.045). Agitation (52.2%) and cognitive symptoms (47.8%) were the most reported neuropsychiatric symptoms. CONCLUSION: We found a high prevalence of delirium in our sample. This finding is in line with recent literature concerning hospitalized COVID-19 patients The higher frequency of COVID-19 symptoms found in the delirium group suggests a possible association between symptomatic SARS-CoV-2 infection and delirium onset.
Introdução: A infecção por SARS-CoV-2 tem sido associada ao desenvolvimento agudo de sintomas mentais e comportamentais e perturbações psiquiátricas. O objetivo deste estudo foi determinar a prevalência de diferentes diagnósticos neuropsiquiátricos em doentes hospitalizados com infeção SARS-CoV-2 avaliados pela Psiquiatria de Ligação. Material e Métodos: Realizámos um estudo transversal num hospital da região de Lisboa, em Portugal. Revimos os processos clínicos dos pacientes internados com um resultado RT-PCR positivo para SARS-CoV-2 avaliados pela Unidade de Psiquiatria de Ligação (UPL) entre fevereiro e dezembro de 2020. Incluímos dados sociodemográficos e clínicos, incluindo quinze sintomas neuropsiquiátricos. A incidência de diferentes diagnósticos psiquiátricos foi o nosso outcome primário. Explorámos também diferenças entre dois grupos: doentes com delirium e doentes sem delirium. Resultados: Incluímos 46 casos [Idade: mediana = 67 anos; amplitude interquartil (AIQ) = 24)], a maioria do sexo masculino (60,9%). Delirium foi o diagnóstico mais frequente na nossa amostra (43,5%), seguido de perturbação depressiva major (21,7%). Doentes com delirium tiveram uma prevalência maior de sintomas de COVID-19 (delirium: 19/20, 95%; sem delirium: 14/26, 53,8%; p = 0,02), bem como um intervalo de tempo mais longo entre um teste RT-PCR SARS-CoV-2 positivo e observação pela UPL (delirium: mediana = 16,5, AIQ = 16; sem delirium: mediana = 8, AIQ = 16,3; p = 0,045). Agitação (52,2%) e sintomas cognitivos (47,8%) foram os sintomas neuropsiquiátricos mais relatados. Conclusão: Foi encontrada na nossa amostra uma elevada prevalência de delirium. Este resultado está de acordo com literatura recente relativamente a doentes internados com COVID-19. A maior frequência de sintomas COVID-19 no grupo com delirium sugere uma possível associação entre infecção sintomática por SARS-CoV-2 e o desenvolvimento desta síndrome.