Department of Psychiatry and Behavioural Neurosciences, Clinician Investigator Program, McMaster University, Hamilton, Canada.
Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.
J Med Case Rep. 2021 Dec 13;15(1):586. doi: 10.1186/s13256-021-03140-6.
Psychiatric disorders increase risk of neuropsychiatric disease and poor outcomes, yet little is known about the neuropsychiatric manifestations of COVID-19 in the psychiatric population. The primary objective is to synthesize neuropsychiatric outcomes of COVID-19 in people with preexisting psychiatric disorders.
Data were collected during an ongoing review of the impact of pandemics on people with existing psychiatric disorders. All study designs and gray literature were included. Medline, PsychInfo, CINAHL, EMBASE, and MedRx were searched from inception to September 1 2020. Risk of bias was assessed using a published tool that can accommodate all study types. Two independent authors screened the studies and extracted data. Data were narratively synthesized, as there were insufficient data to meta-analyze. Evidence was appraised according to GRADE.
Four case reports were included, comprising 13 participants from three countries. Many large-sample, relevant papers were omitted for not reporting psychiatric history, despite reporting other comorbidities. Included participants (n = 13) were hospitalized with COVID-19 and appeared to meet criteria for delirium. Myoclonus, rigidity, and alogia were also reported. The most commonly reported preexisting psychiatric diagnoses were mood disorders, schizophrenia, and alcohol use disorder.
People with preexisting psychiatric disorders may experience delirium, rigidity, myoclonus, and alogia during COVID-19 infection; although higher quality and longitudinal data are needed to better understand these phenomena. Relevant COVID-19 literature does not always report psychiatric history, despite heightened neuropsychiatric vulnerability within this population.
PROSPERO (CRD42020179611).
精神障碍会增加神经精神疾病和不良结局的风险，但人们对精神障碍患者中 COVID-19 的神经精神表现知之甚少。主要目的是综合患有先前存在的精神障碍的人 COVID-19 的神经精神病学结果。
在对现有的精神障碍患者的大流行影响进行的持续审查期间收集了数据。包括所有研究设计和灰色文献。从开始到 2020 年 9 月 1 日，在 Medline、PsychInfo、CINAHL、EMBASE 和 MedRx 上进行了搜索。使用一种可以适应所有研究类型的已发布工具评估偏倚风险。两名独立作者筛选研究并提取数据。由于没有足够的数据进行荟萃分析，因此对数据进行了叙述性综合。根据 GRADE 评估证据。
包括四项病例报告，共涉及来自三个国家的 13 名参与者。尽管报告了其他合并症，但由于未报告精神病史，许多大型相关论文被排除在外。纳入的参与者（n = 13）因 COVID-19 住院，似乎符合谵妄标准。还报告了肌阵挛、僵硬和寡语。最常见的先前存在的精神科诊断是情绪障碍、精神分裂症和酒精使用障碍。
患有先前存在的精神障碍的人在感染 COVID-19 时可能会出现谵妄、僵硬、肌阵挛和寡语；尽管需要更高质量和纵向的数据来更好地了解这些现象。尽管在这一人群中存在更高的神经精神易感性，但相关的 COVID-19 文献并不总是报告精神病史。
PROSPERO（CRD42020179611）。
