Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
Gen Hosp Psychiatry. 2021 Nov-Dec;73:84-100. doi: 10.1016/j.genhosppsych.2021.10.003. Epub 2021 Oct 25.
To describe the comorbidities, presentations, and outcomes of adults with incident psychosis and a history of COVID-19.
We completed a descriptive systematic review of case reports according to PRISMA guidelines, including cases of adult patients with incident psychosis and antecedent or concurrent COVID-19. We extracted patient demographics, comorbidities, clinical course, and outcomes, and assessed cases for quality using a standardized tool.
Of 2396 articles, we included 40 reports from 17 countries, comprising 48 patients. The mean age of patients was 43.9 years and 29 (60%) were males. A total of 7 (15%) had a documented psychiatric history, 6 (13%) had a substance use history and 11 (23%) had a comorbid medical condition. Delusions were the most common (44 [92%]) psychiatric sign and psychosis lasted between 2 and 90 days. A total of 33 (69%) patients required hospitalization to a medical service and 16 (33%) required inpatient psychiatric admission. The majority (26 [54%]) of cases did not assess for delirium and 15 (31%) cases were judged to be of high risk of bias.
Despite the growing awareness of COVID-19's association with incident psychosis at a population level, cases of COVID-19-associated psychosis often lacked clinically relevant details and delirium was frequently not excluded. PROSPERO registration number: CRD42021256746.
描述患有新冠肺炎既往史的首发精神病成年人的合并症、表现和结局。
我们根据 PRISMA 指南完成了一项病例报告的描述性系统评价，包括患有首发精神病和新冠肺炎既往史或同时患有新冠肺炎的成年患者的病例。我们提取了患者的人口统计学资料、合并症、临床过程和结局，并使用标准化工具评估病例的质量。
在 2396 篇文章中，我们纳入了来自 17 个国家的 40 份报告，共涉及 48 名患者。患者的平均年龄为 43.9 岁，29 名（60%）为男性。共有 7 名（15%）有记录的精神病史，6 名（13%）有物质使用史，11 名（23%）有合并的医疗状况。妄想是最常见的（44 例[92%]）精神症状，精神病持续 2 至 90 天。共有 33 名（69%）患者需要住院治疗，16 名（33%）需要住院精神科治疗。大多数（26 例[54%]）病例未评估谵妄，15 例（31%）病例被判断为存在高偏倚风险。
尽管越来越多的人意识到新冠肺炎在人群水平上与首发精神病有关，但新冠肺炎相关精神病的病例往往缺乏临床相关的细节，并且经常未排除谵妄。PROSPERO 注册号：CRD42021256746。
