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卡塔尔100例连续转诊至会诊-联络精神病学服务部门的新冠肺炎患者的特征:谵妄患者与其他精神疾病诊断患者的比较

Characteristics of 100 consecutive patients with COVID-19 referred to consultation-liaison psychiatry services in Qatar: A comparison of patients with delirium versus other psychiatric diagnoses.

作者信息

Iqbal Yousaf, Alabdulla Majid, Kumar Rajeev, Latoo Javed, Albrahim Sultan, Wadoo Ovais, Haddad Ovais

机构信息

Psychiatry Hospital, Hamad Medical Corporation, Doha, Qatar E-mail:

出版信息

Qatar Med J. 2022 Jun 17;2022(3):28. doi: 10.5339/qmj.2022.28. eCollection 2022.

Abstract

INTRODUCTION

Coronavirus disease 2019 (COVID-19) can present with various neuropsychiatric manifestations. This study reports on patients with COVID-19 who were referred to the consultation-liaison (CL) psychiatry services in Qatar and compares the clinical and sociodemographic characteristics of those diagnosed with delirium versus other psychiatric diagnoses.

METHODS

This is a retrospective review of the first 100 consecutive patients with COVID-19 who were referred to the CL services.

RESULTS

Within the total cohort (n=100), most patients (92%) were male, and the mean age was 46 years. About 27% of patients had asymptomatic COVID-19, 35% had a past psychiatric history, and 48% reported pandemic related psychosocial stress. Delirium was the most common psychiatric diagnosis (n=29), followed by acute stress reaction/adjustment disorder, depression, mania, anxiety, non-affective psychosis, and dementia. Among patients with delirium, agitation was the most common symptom (76%), 86% were treated with psychotropic medications, and 17% died. Higher age, longer hospital stays, lower oxygen saturation, lower lymphocytic count, and higher C-reactive protein (CRP) values were significantly associated with delirium versus other psychiatric diagnoses. Higher age and lower oxygen saturations predicted delirium.

CONCLUSION

Delirium was associated with a range of clinical variables and had significant mortality, despite the relatively young age of the patients. COVID-19 should be considered in patients presenting with delirium. Finally, early identification and management of delirium should be integral to COVID-19 protocols.

摘要

引言

2019年冠状病毒病(COVID-19)可表现出各种神经精神症状。本研究报告了卡塔尔被转诊至会诊-联络(CL)精神病学服务部门的COVID-19患者,并比较了诊断为谵妄与其他精神疾病诊断的患者的临床和社会人口学特征。

方法

这是一项对连续转诊至CL服务部门的首批100例COVID-19患者的回顾性研究。

结果

在整个队列(n=100)中,大多数患者(92%)为男性,平均年龄为46岁。约27%的患者患有无症状COVID-19,35%有既往精神病史,48%报告有与疫情相关的社会心理压力。谵妄是最常见的精神疾病诊断(n=29),其次是急性应激反应/适应障碍、抑郁症、躁狂症、焦虑症、非情感性精神病和痴呆症。在谵妄患者中,激越为最常见症状(76%),86%接受了精神药物治疗,17%死亡。与其他精神疾病诊断相比,年龄较大、住院时间较长、血氧饱和度较低、淋巴细胞计数较低以及C反应蛋白(CRP)值较高与谵妄显著相关。年龄较大和血氧饱和度较低可预测谵妄。

结论

尽管患者相对年轻,但谵妄与一系列临床变量相关且死亡率较高。出现谵妄的患者应考虑患有COVID-19。最后,谵妄的早期识别和管理应成为COVID-19诊疗方案的组成部分。

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Delirium: A Marker of Vulnerability in Older People.谵妄:老年人易感性的一个标志
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