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哥伦比亚精神病学协会联络精神病学委员会关于 COVID-19 大流行背景下谵妄诊断与治疗的共识

Consensus of the Liaison-Psychiatry Committee of the Colombian Psychiatric Association on the Diagnosis and Treatment of Delirium in the Context of the COVID-19 Pandemic.

作者信息

Franco José G, Molano Juan Carlos, Rincón Hernán, Velasquez Tirado Juan David, Cardeño Carlos, Patarroyo Rodriguez Liliana, Oviedo Lugo Gabriel Fernando, Bernal Miranda Jaime, Rojas Moreno Monica

机构信息

Escuela de Ciencias de la Salud, Facultad de Medicina, Grupo de Investigación en Psiquiatría de Enlace (GIPE), Universidad Pontificia Bolivariana, Medellín, Colombia.

Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia; Facultad de Medicina, Departamento de Salud Mental, Grupo de Investigación Fundamental: Psiquiatría de Enlace Salud Poblacional, Uniandes, Bogotá, Colombia.

出版信息

Rev Colomb Psiquiatr (Engl Ed). 2020 Dec 2;51(3):245-55. doi: 10.1016/j.rcp.2020.11.008.

Abstract

The pandemic caused by the new coronavirus named SARS-CoV-2 poses unprecedented challenges in the health care. Among them is the increase in cases of delirium. The severe SARS-CoV-2 disease, COVID-19, has common vulnerabilities with delirium and produces alterations in organs such as the lungs or the brain, among others, which have the potential to trigger the mental disorder. In fact, delirium may be the first manifestation of the infection, before fever, general malaise, cough or respiratory disturbances. It is widely supported that delirium increases the morbidity and mortality in those who suffer from it during hospitalization, so it should be actively sought to carry out the relevant interventions. In the absence of evidence on the approach to delirium in the context of COVID-19, this consensus was developed on three fundamental aspects: diagnosis, non-pharmacological treatment and pharmacological treatment, in patients admitted to the general hospital. The document contains recommendations on the systematic use of diagnostic tools, when to hospitalize the patient with delirium, the application of non-pharmacological actions within the restrictions imposed by COVID-19, and the use of antipsychotics, taking into account the most relevant side effects and pharmacological interactions.

摘要

由新型冠状病毒SARS-CoV-2引发的大流行给医疗保健带来了前所未有的挑战。其中之一是谵妄病例的增加。严重的SARS-CoV-2疾病,即新冠肺炎,与谵妄有共同的易感性,并会导致肺部或大脑等器官发生病变,这些病变有可能引发精神障碍。事实上,谵妄可能是感染的首发表现,早于发热、全身不适、咳嗽或呼吸紊乱。人们普遍认为,谵妄会增加住院患者的发病率和死亡率,因此应积极寻求进行相关干预。鉴于在新冠肺炎背景下缺乏关于谵妄治疗方法的证据,本共识针对综合医院收治的患者,在诊断、非药物治疗和药物治疗这三个基本方面达成。该文件包含了关于系统使用诊断工具、何时将谵妄患者住院、在新冠肺炎限制条件下应用非药物措施以及使用抗精神病药物的建议,同时考虑了最相关的副作用和药物相互作用。

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