Du Jinyuan, Zhou Xiaobo, Guo Yi, Jiang Fugui, Yan Mengfan, Zhu Qiong
Department of Neurology, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Department of Psychosomatic, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
Alpha Psychiatry. 2023 Nov 1;24(6):276-282. doi: 10.5152/alphapsychiatry.2023.231266. eCollection 2023 Nov.
It has been reported that coronavirus disease 2019 (COVID-19) may cause psychiatric disorders, but there are too many confounding factors in the various studies, making it difficult to draw accurate conclusions.
We analyzed the clinical features and treatment of patients with non-severe COVID-19 who were hospitalized in neurology and psychiatry departments due to acute psychiatric disorders and performed a descriptive analysis.
Of the 57 patients included, 65% were hospitalized in the neurology department. Eighty-two percent of the patients exhibited abnormal mental behavior 1 week or less after COVID-19 diagnosis, and more than 60% of the patients had normal electroencephalogram (EEG), head imaging, autoimmune encephalitis antibody, and cerebrospinal fluid (CSF) results. Abnormal EEG results included an increase in nonspecific slow waves, abnormal imaging results included small ischemic areas and lacunar infarctions, and abnormal CSF results included a slight increase in cell numbers and protein levels and an increase in pressure. After administering antipsychotic drugs and/or immunotherapy, 67% of the patients experienced improvement in their psychiatric disorders by the time of discharge. Thirty-nine percent of the patients were discharged without antipsychotic medication and experienced no relapse of psychiatric symptoms.
Patients with non-severe COVID-19 and psychiatric disorders usually have a good prognosis and do not require long-term antipsychotic medication. Patients with uncontrollable mental symptoms experienced rapid remission after immunotherapy, suggesting that inflammation or the immune response may play an important role in the occurrence of simple acute psychiatric disorders caused by COVID-19.
据报道，2019冠状病毒病（COVID-19）可能导致精神障碍，但各项研究中存在太多混杂因素，难以得出准确结论。
我们分析了因急性精神障碍入住神经内科和精神科的非重症COVID-19患者的临床特征及治疗情况，并进行描述性分析。
纳入的57例患者中，65%入住神经内科。82%的患者在COVID-19诊断后1周或更短时间内出现精神行为异常，60%以上患者的脑电图（EEG）、头部影像学、自身免疫性脑炎抗体及脑脊液（CSF）检查结果正常。EEG异常结果包括非特异性慢波增多，影像学异常结果包括小缺血灶和腔隙性脑梗死，CSF异常结果包括细胞数和蛋白水平轻度升高及压力升高。给予抗精神病药物和/或免疫治疗后，67%的患者在出院时精神障碍有所改善。39%的患者出院时未服用抗精神病药物，且精神症状未复发。
非重症COVID-19合并精神障碍的患者通常预后良好，无需长期服用抗精神病药物。精神症状无法控制的患者在免疫治疗后迅速缓解，提示炎症或免疫反应可能在COVID-19所致单纯急性精神障碍的发生中起重要作用。
