The significance of the library's physical space: how COVID-19 impacted a consumer health service.

Background: During the beginning of the COVID-19 pandemic, many consumer health libraries were forced to close their doors to patrons. At the Health Information Center in Knoxville, Tennessee, the physical space closed, while health information services continued to be provided via phone and email. To examine the impact of lack of access to a physical library for consumer health information, researchers analyzed the number of health information requests pre-COVID-19 pandemic compared to during the initial phase of the pandemic. Case Presentation: Data from an internal database was collected and analyzed. Researchers divided the data into three time periods: March 2018 to February 2019 (Phase 1), March 2019 to February 2020 (Phase 2), and March 2020 to February 2021 (Phase 3). Data was de-identified and duplicate entries were removed. The type of interaction and request topics were reviewed in each phase. Conclusion: In Phase 1, there were 535 walk-ins to request health information and 555 walk-ins in Phase 2. In Phase 3, there were 40 walk-ins. The number of requests through phone and email varied but remained steady. There was a 61.56% decrease in requests between Phase 1 and Phase 3 while there was a 66.27% decrease between Phase 2 and Phase 3 due to the lack of walk-in requests. The number of phone and email requests did not increase despite the closure of the physical library space to the public. Access to the physical space plays a significant role in providing health information requests to patients and family members.

Neurology and neuropsychiatry of COVID-19: A systematic review and meta-analysis of the early literature reveals frequent CNS manifestations and key emerging narratives

There is accumulating evidence of the neurological and neuropsychiatric features of infection with SARS-CoV-2. In this systematic review and meta-analysis, we aimed to describe the characteristics of the early literature and estimate point prevalences for neurological and neuropsychiatric manifestations. We searched MEDLINE, Embase, PsycINFO and CINAHL up to 18 July 2020 for randomised controlled trials, cohort studies, case-control studies, cross-sectional studies and case series. Studies reporting prevalences of neurological or neuropsychiatric symptoms were synthesised into meta-analyses to estimate pooled prevalence. 13 292 records were screened by at least two authors to identify 215 included studies, of which there were 37 cohort studies, 15 case-control studies, 80 cross-sectional studies and 83 case series from 30 countries. 147 studies were included in the meta-analysis. The symptoms with the highest prevalence were anosmia (43.1% (95% CI 35.2% to 51.3%), n = 15 975, 63 studies), weakness (40.0% (95% CI 27.9% to 53.5%), n = 221, 3 studies), fatigue (37.8% (95% CI 31.6% to 44.4%), n = 21 101, 67 studies), dysgeusia (37.2% (95% CI 29.8% to 45.3%), n = 13 686, 52 studies), myalgia (25.1% (95% CI 19.8% to 31.3%), n = 66 268, 76 studies), depression (23.0% (95% CI 11.8% to 40.2%), n = 43 128, 10 studies), headache (20.7% (95% CI 16.1% to 26.1%), n = 64 613, 84 studies), anxiety (15.9% (5.6% to 37.7%), n = 42 566, 9 studies) and altered mental status (8.2% (95% CI 4.4% to 14.8%), n = 49 326, 19 studies). Heterogeneity for most clinical manifestations was high.Neurological and neuropsychiatric symptoms of COVID-19 in the pandemic's early phase are varied and common. The neurological and psychiatric academic communities should develop systems to facilitate high-quality methodologies, including more rapid examination of the longitudinal course of neuropsychiatric complications of newly emerging diseases and their relationship to neuroimaging and inflammatory biomarkers. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Persistent neuropsychiatric symptoms after COVID-19: a systematic review and meta-analysis.

The nature and extent of persistent neuropsychiatric symptoms after COVID-19 are not established. To help inform mental health service planning in the pandemic recovery phase, we systematically determined the prevalence of neuropsychiatric symptoms in survivors of COVID-19. For this pre-registered systematic review and meta-analysis (PROSPERO ID CRD42021239750), we searched MEDLINE, EMBASE, CINAHL and PsycINFO to 20 February 2021, plus our own curated database. We included peer-reviewed studies reporting neuropsychiatric symptoms at post-acute or later time-points after COVID-19 infection and in control groups where available. For each study, a minimum of two authors extracted summary data. For each symptom, we calculated a pooled prevalence using generalized linear mixed models. Heterogeneity was measured with I 2. Subgroup analyses were conducted for COVID-19 hospitalization, severity and duration of follow-up. From 2844 unique titles, we included 51 studies (n = 18 917 patients). The mean duration of follow-up after COVID-19 was 77 days (range 14-182 days). Study quality was most commonly moderate. The most prevalent neuropsychiatric symptom was sleep disturbance [pooled prevalence = 27.4% (95% confidence interval 21.4-34.4%)], followed by fatigue [24.4% (17.5-32.9%)], objective cognitive impairment [20.2% (10.3-35.7%)], anxiety [19.1% (13.3-26.8%)] and post-traumatic stress [15.7% (9.9-24.1%)]. Only two studies reported symptoms in control groups, both reporting higher frequencies in COVID-19 survivors versus controls. Between-study heterogeneity was high (I 2 = 79.6-98.6%). There was little or no evidence of differential symptom prevalence based on hospitalization status, severity or follow-up duration. Neuropsychiatric symptoms are common and persistent after recovery from COVID-19. The literature on longer-term consequences is still maturing but indicates a particularly high prevalence of insomnia, fatigue, cognitive impairment and anxiety disorders in the first 6 months after infection.

COVID-19 and psychosis risk: Real or delusional concern?

Historical epidemiological perspectives from past pandemics and recent neurobiological evidence link infections and psychoses, leading to concerns that COVID-19 will present a significant risk for the development of psychosis. But are these concerns justified, or mere sensationalism? In this article we review the historical associations between viral infection and the immune system more broadly in the development of psychosis, before critically evaluating the current evidence pertaining to SARS-CoV-2 and risk of psychosis as an acute or post-infectious manifestation of COVID-19. We review the 42 cases of psychosis reported in infected patients to date, and discuss the potential implications of in utero infection on subsequent neurodevelopment and psychiatric risk. Finally, in the context of the wider neurological and psychiatric manifestations of COVID-19 and our current understanding of the aetiology of psychotic disorders, we evaluate possible neurobiological and psychosocial mechanisms as well as the numerous challenges in ascribing a causal pathogenic role to the infection.

Prospective studies are needed of the neurology and neuropsychiatry of COVID-19: reply.

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