Demographic Features, Physical Examination Findings, and Medication Use in Hospitalized, Delirious Patients With and Without COVID-19 Infection: A Retrospective Study.
Demographic Features, Physical Examination Findings, and Medication Use in Hospitalized, Delirious Patients With and Without COVID-19 Infection: A Retrospective Study.
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DOI：
10.1016/j.jaclp.2022.07.010
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发表时间：
2023-01
影响因子：
2.3
通讯作者：
Beach, Scott R.
中科院分区：
文献类型：
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作者：
Beckwith, Noor;Probert, Julia;Rosenbaum, Blake L.;Bains, Ashika;Angelucci, Victoria C.;Rodriguez, Alejandra E. Morfin;London, Stephanie;Zollman, Joshua W.;Ordonez, Andrea Soto;Kontos, Nicholas;Smith, Felicia A.;Celano, Christopher M.;Beach, Scott R.
谵妄在感染严重急性呼吸综合征冠状病毒2的情况下很常见。轶事证据和病例报告表明，在2019冠状病毒病（COVID - 19）情况下出现谵妄的患者可能表现出特定特征，包括肌张力增高、意志缺乏和言语贫乏。
为了确定因精神科会诊而转诊的患有和未患有COVID - 19感染的谵妄患者在社会人口统计学和医学特征、体格检查结果以及药物使用方面是否存在差异。
我们对2020年3月10日至5月15日在一家三级医院精神科会诊服务所见的486名患者进行了一项探索性回顾性病历审查。谵妄患者由精神科顾问通过临床检查诊断，这些患者根据COVID - 19感染状况进行分层。使用双变量分析对社会人口统计学、病史、客观指标和治疗相关变量进行描述和比较各层情况。
在研究期间，共有109名患者被诊断为谵妄。其中36名患者COVID - 19检测呈阳性。中位年龄为63岁，两组之间无差异。患有谵妄的COVID - 19阳性患者更有可能来自护理机构（39%对11%；费舍尔精确检验；P = 0.001），并且有精神分裂症病史（11%对0%；费舍尔精确检验；P = 0.011）。肌阵挛（28%对4%；P = 0.002）、肌张力亢进（36%对10%；P = 0.003）、退缩（36%对15%；P = 0.011）、运动不能（19%对6%；P = 0.034）、意志缺乏（19%对3%；P = 0.004）和言语贫乏（25%对8%；P = 0.012）在COVID - 19阳性患者中更为常见。患有谵妄的COVID - 19阳性患者在某个时候更有可能接受过氯胺酮（28%对7%；P = 0.006）、除右美托咪定之外的α - 肾上腺素能药物（36%对14%；P = 0.014）以及肠道抗精神病药物（92%对66%；P = 0.007）。
因精神科会诊而转诊的患有COVID - 19谵妄的患者比未患有COVID - 19的谵妄患者更有可能居住在护理机构，并且有精神分裂症病史。在COVID - 19情况下出现谵妄的患者可能表现出与运动不能性缄默症一致的特征。精神科医生必须对这些特征进行评估，因为它们可能影响治疗选择以及谵妄情况下常用药物的副作用风险。
Delirium is common in the setting of infection with severe acute respiratory syndrome coronavirus 2. Anecdotal evidence and case reports suggest that patients with delirium in the setting of Coronavirus 2019 (COVID-19) may exhibit specific features, including increased tone, abulia, and alogia. To determine whether differences exist in sociodemographic and medical characteristics, physical examination findings, and medication use in delirious patients with and without COVID-19 infection referred for psychiatric consultation. We undertook an exploratory, retrospective chart review of 486 patients seen by the psychiatry consultation service at a tertiary care hospital from March 10 to May 15, 2020. Delirious patients were diagnosed via clinical examination by a psychiatric consultant, and these patients were stratified by COVID-19 infection status. The strata were described and compared using bivariate analyses across sociodemographic, historical, objective, and treatment-related variables. A total of 109 patients were diagnosed with delirium during the study period. Thirty-six were COVID-19+. Median age was 63 years and did not differ between groups. COVID-19+ patients with delirium were more likely to present from nursing facilities (39% vs 11%; Fisher's exact test; P = 0.001) and have a history of schizophrenia (11% vs 0%; Fisher's exact test; P = 0.011). Myoclonus (28% vs 4%; P = 0.002), hypertonia (36% vs 10%; P = 0.003), withdrawal (36% vs 15%; P = 0.011), akinesia (19% vs 6%; P = 0.034), abulia (19% vs 3%; P = 0.004), and alogia (25% vs 8%; P = 0.012) were more common in COVID-19+ patients. COVID-19+ delirious patients were significantly more likely to have received ketamine (28% vs 7%; P = 0.006), alpha-adrenergic agents besides dexmedetomidine (36% vs 14%; P = 0.014), and enteral antipsychotics (92% vs 66%; P = 0.007) at some point. Patients with COVID-19 delirium referred for psychiatric consultation are more likely to reside in nursing facilities and have a history of schizophrenia than delirious patients without COVID-19. Patients with delirium in the setting of COVID-19 may exhibit features consistent with akinetic mutism. Psychiatrists must assess for such features, as they may influence management choices and the risk of side effects with agents commonly used in the setting of delirium.
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影响因子：
168.9
作者：
Inouye, Sharon K.;Westendorp, Rudi G. J.;Saczynski, Jane S.
通讯作者：
Saczynski, Jane S.
DOI：
10.1016/j.psym.2020.09.002
发表时间：
2021-01-01
影响因子：
2.3
作者：
Amouri, Jamelleh;Andrews, Patricia S.;Wilson, Jo Ellen
通讯作者：
Wilson, Jo Ellen
影响因子：
6.3
作者：
Garcez, Flavia B.;Aliberti, Marlon J. R.;Avelino-Silva, Thiago J.
通讯作者：
Avelino-Silva, Thiago J.
影响因子：
3.8
作者：
Mcloughlin, Benjamin C.;Miles, Amy;Davis, Daniel
通讯作者：
Davis, Daniel
为什么OMICRON变体在很大程度上备用嗅觉功能？ 2019年冠状病毒病中厌食的发病机理的意义。
DOI：
10.1093/infdis/jiac113
发表时间：
2022-10-17
期刊：
The Journal of infectious diseases
影响因子：
--
作者：
通讯作者：
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