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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 大流行背景下谵妄的诊断和治疗的共识。

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.

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). 2022 Jul-Sep;51(3):245-255. doi: 10.1016/j.rcpeng.2020.11.008. Epub 2022 Sep 1.

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 引起的大流行给医疗保健带来了前所未有的挑战。其中包括谵妄病例的增加。严重的 SARS-CoV-2 疾病 COVID-19 与谵妄有共同的脆弱性,并会导致肺部或大脑等器官的改变,这些都有可能引发精神障碍。事实上,谵妄可能是感染的首发症状,早于发热、全身不适、咳嗽或呼吸紊乱等症状。广泛认为,谵妄会增加住院患者的发病率和死亡率,因此应积极寻求相关干预措施。鉴于 COVID-19 背景下谵妄治疗方法缺乏证据,本共识主要针对综合医院收治的患者,就诊断、非药物治疗和药物治疗三个基本方面达成了一致意见。该文件就诊断工具的系统使用、何时将谵妄患者收入院、在 COVID-19 限制范围内实施非药物治疗、以及考虑到最相关的副作用和药物相互作用时使用抗精神病药物等方面提出了建议。

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