Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University of Chieti, Chieti, Italy.
Department of Pharmacy, Pharmacology, Clinical Science, University of Hertfordshire, Hatfield, Herts, UK.
Neurol Sci. 2021 Oct;42(10):3981-3988. doi: 10.1007/s10072-021-05461-2. Epub 2021 Jul 28.
Although recent data show that SARS-CoV-2 infection seems to affect the central nervous system (CNS), little is known about the neuropsychiatric effects resulting from this condition. In addition to the well-known neurotrophism of coronaviruses, recent evidence shows also that the "cytokine storm" induced by the infection is at the basis of the neuroinflammation of the CNS. Furthermore, prolonged hospitalization, polypharmacotherapy, and isolation could be at the basis of the onset of delirium in hospitalized COVID patients. This multicentric observational study explores the incidence of the onset of delirium in an Italian cohort of SARS-CoV-2 positive inpatients.
Data were collected in the COVIDhospitals of Brescia, Bergamo, Chieti, and Genova. Different socio-demographic, medical, neurological, and pharmacological parameters were collected. As a rapid screening for delirium, the 4AT scale was used. Eighty COVID-19 inpatients (mean age 74.7 ± 14.5 years) met the inclusion criteria (confirmed positivity to the SARS-CoV-2 virus; the presence of delirium and/or psychomotor agitation and/or new onset of other neuropsychiatric symptoms during hospitalization).
The majority of these patients (68.8%) had "hyperactive delirium" subtype. Polypharmacotherapy, current treatment with corticosteroids, and higher age were associated with delirium severity.
These data provide an insight into the onset of delirium among COVID-19 patients underlining the need for monitoring, especially in elderly patients, the neuropsychiatric symptoms, and the therapy in order to have shorter hospitalization times and better outcomes.
尽管最近的数据表明，SARS-CoV-2 感染似乎会影响中枢神经系统（CNS），但对于由此引起的神经精神影响知之甚少。除了冠状病毒众所周知的神经营养作用外，最近的证据还表明，感染引起的“细胞因子风暴”是 CNS 神经炎症的基础。此外，住院时间延长、多药物治疗和隔离可能是住院 COVID 患者发生谵妄的基础。这项多中心观察性研究探讨了意大利 SARS-CoV-2 阳性住院患者中谵妄发病的发生率。
数据收集于布雷西亚、贝加莫、基耶蒂和热那亚的 COVID 医院。收集了不同的社会人口统计学、医学、神经学和药理学参数。作为谵妄的快速筛查，使用了 4AT 量表。80 名符合纳入标准的 COVID-19 住院患者（平均年龄 74.7 ± 14.5 岁）入选（SARS-CoV-2 病毒检测阳性；住院期间出现谵妄和/或精神运动激越和/或新发其他神经精神症状）。
这些患者中大多数（68.8%）存在“活跃型谵妄”亚型。多药物治疗、当前皮质类固醇治疗和较高年龄与谵妄严重程度相关。
这些数据深入了解 COVID-19 患者谵妄的发病情况，强调需要监测，特别是老年患者的神经精神症状和治疗，以缩短住院时间并获得更好的结局。
