Delirium and other neuropsychiatric manifestations of COVID-19 infection in people with preexisting psychiatric disorders: a systematic review

Abstract Background 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. Methods 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. Results 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. Conclusions 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. Trial Registration: PROSPERO (CRD42020179611).

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Topics of spirituality in neonatology – Results from a systematic literature review

Spiritual Care ◽

10.1515/spircare-2016-0135 ◽

2016 ◽

Vol 5 (4) ◽

pp. 303-310 ◽

Cited By ~ 1

Author(s):

Michael Thiel

Keyword(s):

Literature Review ◽

Systematic Literature Review ◽

Medical Staff ◽

Case Reports ◽

Meta Analysis ◽

Long Term Outcomes ◽

Difficult Situation ◽

Study Designs ◽

The Impact

AbstractIntroductionThe prognosis of preterms and ill newborns has improved substantially during the last decades. Besides conventional methods, additional interventions play an important role in this development. Managing parents' needs under the circumstances of intensive care can be a crucial aspect of dealing with this difficult situation. But data on this group has not been systematically evaluated so far.MethodWe performed a systematic literature review following the PRISMA criteria. Keywords were neonates, neonatology, newborn, preterm, parents, and spirituality. All study types in English and German were included.ResultsAfter evaluating the abstracts of the initial search results, we considered 33 studies eligible for analysis. Study types are surveys, interviews (qualitative studies), case reports, and reviews. Topics were parents, ethnical differences, medical staff, and palliative care.DiscussionThere is a variety of studies on spirituality in neonatology with a broad spectrum of study types. A meta-analysis is difficult, especially because of the heterogeneity of the study designs, patient numbers and questionnaires used. Although the studies are promising, short-term and long-term outcomes have not been evaluated yet. Interesting endpoints such as the influence on mortality, morbidity and duration of hospital stay cannot be stated. Thus it is too early to derive practical recommendations for the medical staff from these studies.ConclusionAlthough there is a body of data on spirituality in neonatology that addresses several important aspects, even more studies on the impact of parents' needs and the consequences for the medical staff are required.

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The Impact of Appetite-Regulating Neuropeptide Leptin on Alcohol Use, Alcohol Craving and Addictive Behavior: A Systematic Review of Preclinical and Clinical Data

Alcohol and Alcoholism ◽

10.1093/alcalc/agaa044 ◽

2020 ◽

Author(s):

Patrick Bach ◽

Anne Koopmann ◽

Falk Kiefer

Keyword(s):

Substance Use ◽

Alcohol Use ◽

Substance Use Disorders ◽

Clinical Data ◽

Alcohol Use Disorder ◽

English Language ◽

Leptin Receptor ◽

Case Reports ◽

Alcohol Craving ◽

The Impact

Abstract Aims The appetite regulating hormone leptin, which is mainly secreted from adipose tissue, is an important regulator of food intake and modulator of reward-driven behavior. Leptin exerts its biological actions via binding to the leptin receptor, which is expressed in the hypothalamus, but also in the hippocampus, the amygdala and the substantia nigra. In the ventral tegmental area (VTA), leptin attenuates the firing rate of dopaminergic neurons that project to the Nucleus accumbens (NAc), which serves as relay to other brain areas of the “addiction network”, such as the prefrontal cortex. This suggests that leptin plays a role in the processing of rewards in the context of substance use disorders such as alcohol use disorder, especially through attenuation of dopaminergic activity in the mesolimbic reward system. This supports the plausibility of leptin’s potential effects in alcohol use disorder. Methods We searched MEDLINE from 1990 to February 2020. All abstracts were screened for relevance and we only included publications reporting original data with a full text available in English language. Studies that did not report leptin-data, reviews or case reports/series were not included. Results We identified a total of N=293 studies of whom a total of N=55 preclinical and clinical studies met the specified criteria. N=40 studies investigated the effects of alcohol on leptin plasma levels, N=9 studies investigated the effects of leptin on alcohol craving and N=6 studies investigated the effects of leptin on relapse and alcohol consumption. Conclusions In this review of preclinical and clinical data, we assess the role of leptin in alcohol use and the development and maintenance of an alcohol use disorder, alcohol craving and relapse. Integrating the existing preclinical and clinical data on leptin may reveal new and innovative targets for the treatment of substance use disorders in the future.

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Are multi-cat homes more stressful? A critical review of the evidence associated with cat group size and wellbeing

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x211013741 ◽

2021 ◽

pp. 1098612X2110137

Author(s):

Lauren R Finka ◽

Rachel Foreman-Worsley

Keyword(s):

Outcome Measures ◽

Group Size ◽

Evidence Base ◽

Primary Objective ◽

Current Evidence ◽

Housing Conditions ◽

Future Studies ◽

Domestic Environments ◽

Study Designs ◽

The Impact

Objectives The primary objective of this review was to conduct a systematic critical appraisal of published literature, in order to assess the evidence regarding the impact of cat group size on cat wellbeing in the domestic home. The secondary objectives were to: (i) identify additional social and environmental mediators of cat wellbeing in these contexts; and (ii) identify general limitations within the current evidence and provide recommendations for future studies. Methods A systematic search of electronic databases (Scopus, Web of Science and Google Scholar) was conducted using targeted Boolean phrasing. Papers were retained for appraisal of full text where they included a comparison of both single (n = 1) and multi-cat (n ⩾2) domestic housing conditions and/or comparison of different multi-cat group sizes, within a single study; or where they compared outcome measures that were either behavioural and/or physiological and deemed as relevant indicators of cat wellbeing. Results A total of 1334 unique papers were returned, 15 of which were retained. Of these papers, only four stated their primary aim to be an investigation of links between cat group size and cat wellbeing. Overall, the reviewed papers did not indicate consistent directions of effects regarding cat group size and outcome measures relevant to wellbeing. This was similar for the other social and environmental mediators identified. Conclusions and relevance Inconsistency in results is likely due to the substantial methodological variation, limitations in measures used as indicators of wellbeing and limitations in general study designs and reporting. Results also highlight the complex, multifactorial relationships between cat wellbeing and various social and environmental factors. These may be as, if not more, important than absolute numbers of cats residing within a household. Due to the various limitations and general paucity of research, further studies are recommended to provide a suitable evidence base regarding impacts of multi-cat living on cat wellbeing in domestic environments.

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Dietary Vitamin and Stability of Oral Anticoagulation: Proposal of a Diet with Constant Vitamin K1 Content

Thrombosis and Haemostasis ◽

10.1055/s-0038-1655997 ◽

1997 ◽

Vol 77 (03) ◽

pp. 504-509 ◽

Cited By ~ 47

Author(s):

Sarah L Booth ◽

Jacqueline M Charnley ◽

James A Sadowski ◽

Edward Saltzman ◽

Edwin G Bovill ◽

...

Keyword(s):

Dietary Intake ◽

Vitamin K ◽

High Performance ◽

Case Reports ◽

Food Composition ◽

Dietary Guidelines ◽

Dietary Vitamin ◽

Vitamin K1 ◽

The Stability ◽

The Impact

SummaryCase reports cited in Medline or Biological Abstracts (1966-1996) were reviewed to evaluate the impact of vitamin K1 dietary intake on the stability of anticoagulant control in patients using coumarin derivatives. Reported nutrient-drug interactions cannot always be explained by the vitamin K1 content of the food items. However, metabolic data indicate that a consistent dietary intake of vitamin K is important to attain a daily equilibrium in vitamin K status. We report a diet that provides a stable intake of vitamin K1, equivalent to the current U.S. Recommended Dietary Allowance, using food composition data derived from high-performance liquid chromatography. Inconsistencies in the published literature indicate that prospective clinical studies should be undertaken to clarify the putative dietary vitamin K1-coumarin interaction. The dietary guidelines reported here may be used in such studies.

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Glucose Levels and Outcome After Primary Intraventricular Hemorrhage

Current Neurovascular Research ◽

10.2174/1567202616666190131164108 ◽

2019 ◽

Vol 16 (1) ◽

pp. 40-46

Author(s):

Rui Guo ◽

Ruiqi Chen ◽

Chao You ◽

Lu Ma ◽

Hao Li ◽

...

Keyword(s):

Diabetes Mellitus ◽

Blood Glucose ◽

Blood Glucose Level ◽

Incidence Rate ◽

Glucose Level ◽

Intraventricular Hemorrhage ◽

Laboratory Data ◽

History Of ◽

Poor Outcomes ◽

The Impact

Background and Purpose: Hyperglycemia is reported to be associated with poor outcome in patients with spontaneous Intracerebral Hemorrhage (ICH), but the association between blood glucose level and outcomes in Primary Intraventricular Hemorrhage (PIVH) remains unclear. We sought to identify the parameters associated with admission hyperglycemia and analyze the impact of hyperglycemia on clinical outcome in patients with PIVH. Methods: Patients admitted to Department of Neurosurgery, West China Hospital with PIVH between 2010 and 2016 were retrospectively included in our study. Clinical, radiographic, and laboratory data were collected. Univariate and multivariate logistic regression analyses were used to identify independent predictors of poor outcomes. Results: One hundred and seventy patients were included in the analysis. Mean admission blood glucose level was 7.78±2.73 mmol/L and 10 patients (5.9%) had a history of diabetes mellitus. History of diabetes mellitus (P = 0.01; Odds Ratio [OR], 9.10; 95% Confidence Interval [CI], 1.64 to 50.54) was independent predictor of admission critical hyperglycemia defined at 8.17 mmol/L. Patients with admission critical hyperglycemia poorer outcome at discharge (P < 0.001) and 90 days (P < 0.001). After adjustment, admission blood glucose was significantly associated with discharge (P = 0.01; OR, 1.30; 95% CI, 1.06 to 1.59) and 90-day poor outcomes (P = 0.03; OR, 1.27; 95% CI, 1.03 to 1.58), as well as mortality at 90 days (P = 0.005; OR, 1.41; 95% CI, 1.11 to 1.78). In addition, admission critical hyperglycemia showed significantly increased the incidence rate of pneumonia in PIVH (P = 0.02; OR, 6.04; 95% CI 1.27 to 28.80) even after adjusting for the confounders. Conclusion: Admission blood glucose after PIVH is associated with discharge and 90-day poor outcomes, as well as mortality at 90 days. Admission hyperglycemia significantly increases the incidence rate of pneumonia in PIVH.

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Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)

Journal of Neurology ◽

10.1007/s00415-021-10406-y ◽

2021 ◽

Author(s):

Biyan Nathanael Harapan ◽

Hyeon Joo Yoo

Keyword(s):

Severe Acute Respiratory Syndrome ◽

Case Reports ◽

Case Series ◽

Altered Mental Status ◽

Neurological Complications ◽

Neurological Symptoms ◽

Neurological Manifestations ◽

Fisher Syndrome ◽

Novel Coronavirus ◽

The Impact

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and was first identified in Wuhan, China in December 2019. It is evident that the COVID-19 pandemic has become a challenging world issue. Although most COVID-19 patients primarily develop respiratory symptoms, an increasing number of neurological symptoms and manifestations associated with COVID-19 have been observed. In this narrative review, we elaborate on proposed neurotropic mechanisms and various neurological symptoms, manifestations, and complications of COVID-19 reported in the present literature. For this purpose, a review of all current published literature (studies, case reports, case series, reviews, editorials, and other articles) was conducted and neurological sequelae of COVID-19 were summarized. Essential and common neurological symptoms including gustatory and olfactory dysfunctions, myalgia, headache, altered mental status, confusion, delirium, and dizziness are presented separately in sections. Moreover, neurological manifestations and complications that are of great concern such as stroke, cerebral (sinus) venous thrombosis, seizures, meningoencephalitis, Guillain–Barré syndrome, Miller Fisher syndrome, acute myelitis, and posterior reversible encephalopathy syndrome (PRES) are also addressed systematically. Future studies that examine the impact of neurological symptoms and manifestations on the course of the disease are needed to further clarify and assess the link between neurological complications and the clinical outcome of patients with COVID-19. To limit long-term consequences, it is crucial that healthcare professionals can early detect possible neurological symptoms and are well versed in the increasingly common neurological manifestations and complications of COVID-19.

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Efficacy and safety of urate-lowering therapy in people with kidney impairment: a GCAN-initiated literature review

Rheumatology Advances in Practice ◽

10.1093/rap/rkaa073 ◽

2021 ◽

Author(s):

Hamish Farquhar ◽

Ana B Vargas-Santos ◽

Huai Leng Pisaniello ◽

Mark Fisher ◽

Catherine Hill ◽

...

Keyword(s):

Renal Function ◽

Renal Impairment ◽

Case Reports ◽

Serum Urate ◽

Cochrane Library ◽

Future Studies ◽

Kidney Impairment ◽

The Cochrane Library ◽

Study Designs ◽

Different Levels

Abstract Objectives To evaluate the efficacy, defined as achieving target serum urate <6.0 mg/dl, and safety of urate-lowering therapies (ULT) for people with gout and CKD stages 3–5. Methods PubMed, The Cochrane Library, and EMBASE, were searched from 1 January 1959 to 31 January 2018 for studies that enrolled people with gout, who had an estimated glomerular filtration rate (eGFR) or creatinine clearance (CrCl) of < 60 mL/min, and exposure to allopurinol, febuxostat, probenecid, benzbromarone, lesinurad or pegloticase. All study designs other than case reports were included, except for people on dialysis, for which we did include case reports. Results There were 36 reports with an analysis of efficacy and/or safety based upon renal function – allopurinol (n = 12), febuxostat (n = 10), probenecid (n = 3), benzbromarone (n = 5), lesinurad (n = 5), and pegloticase (n = 1). There were 108 reports that involved people with gout and renal impairment but did not contain any analysis on efficacy and/or safety based upon renal function – allopurinol (n = 84), febuxostat (n = 14), benzbromarone (n = 1), lesinurad (n = 3), and pegloticase (n = 6). Most studies excluded people with more severe degrees of renal impairment (eGFR or CrCl of < 30mL/min). For allopurinol in particular, there was significant variability in the dose of drug used, and efficacy in terms of urate lowering, across all levels of renal impairment. Conclusion There is a lack of evidence regarding efficacy and/or safety of currently used ULT according to different levels of renal function. Future studies should include patients with CKD and should report study outcomes stratified by renal function.

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Risk of Nursing Home Use Among Older Americans: The Impact of Psychiatric History and Trajectories of Cognitive Function

The Journals of Gerontology Series B ◽

10.1093/geronb/gbab045 ◽

2021 ◽

Author(s):

Maria T Brown ◽

Miriam Mutambudzi

Keyword(s):

Nursing Home ◽

Cognitive Function ◽

Latent Class ◽

Study Data ◽

Psychiatric Training ◽

Psychiatric History ◽

Term Care ◽

Increased Risk ◽

Course Variables ◽

The Impact

Abstract Objectives Mental illness and cognitive functioning may be independently associated with nursing home use. We investigated the strength of the association between baseline (1998) psychiatric history, 8-year cognitive function trajectories, and prospective incidence of nursing home use over a 10-year period while accounting for relevant covariates in U.S. adults aged 65 and older. We hypothesized that self-reported baseline history of psychiatric, emotional, or nervous problems would be associated with a greater risk of nursing home use and that cognition trajectories with the greatest decline would be associated with a subsequent higher risk of nursing home use. Methods We used 8 waves (1998–2016) of Health and Retirement Study data for adults aged 65 years and older. Latent class mixture modeling identified 4 distinct cognitive function trajectory classes (1998–2006): low-declining, medium-declining, medium-stable, and high-declining. Participants from the 1998 wave (N = 5,628) were classified into these 4 classes. Competing risks regression analysis modeled the subhazard ratio of nursing home use between 2006 and 2016 as a function of baseline psychiatric history and cognitive function trajectories. Results Psychiatric history was independently associated with greater risk of nursing home use (subhazard ratio [SHR] 1.26, 95% confidence interval [CI] 1.06–1.51, p < .01), net the effects of life course variables. Furthermore, “low-declining” (SHR 2.255, 95% CI 1.70–2.99, p < .001) and “medium-declining” (2.103, 95% CI 1.69–2.61, p < .001) trajectories predicted increased risk of nursing home use. Discussion Evidence of these associations can be used to educate policymakers and providers about the need for appropriate psychiatric training for staff in community-based and residential long-term care programs.

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Sensory Loss and Delirium Among Medicare Beneficiaries

Innovation in Aging ◽

10.1093/geroni/igaa057.2890 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 797-797

Author(s):

Emmanuel Garcia Morales ◽

Nicholas Reed

Keyword(s):

Claims Data ◽

Sensory Deprivation ◽

Vision Impairment ◽

Sensory Loss ◽

Future Research ◽

Sensory Impairment ◽

Medicare Beneficiaries ◽

Increase Risk ◽

The Impact ◽

Dual Sensory Impairment

Abstract Sensory impairment is prevalent among older adults and may increase risk for delirium via mechanisms including sensory deprivation and poor communication which may result in confusion and agitation. In the Medicare Current Beneficiary Study (MCBS), delirium was measured using a validated algorithm of claims data. Sensory impairment was defined as any self-reported trouble hearing or seeing, with the use of aids, and was categorized as no impairment, hearing impairment only (HI), vision impairment only (VI), and dual sensory impairment (DSI). Among, 3,240 hospitalized participants in 2016-2017, 346 (10.7%) experienced delirium. In a model adjusted for socio-demographic and health characteristics, those with HI only, VI only, and DSI had 0.84 (95% CI: 0.6-1.3), 1.1 (95% CI 0.7-1.7), and 1.5 (95% CI 1.0-2.1) times the odds of experiencing delirium compared to those without sensory impairment. Future research should focus on mechanisms underlying association and determine the impact of treatment of sensory loss.

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Digital Addiction: Systematic Review of Computer Game Addiction Impact on Adolescent Physical Health

Electronics ◽

10.3390/electronics10090996 ◽

2021 ◽

Vol 10 (9) ◽

pp. 996

Author(s):

Norshakirah Aziz ◽

Md Jan Nordin ◽

Said Jadid Abdulkadir ◽

Muhammad Muhaimin M. Salih

Keyword(s):

Physical Health ◽

Computer Games ◽

Relevant Literature ◽

Primary Objective ◽

Extensive Literature ◽

Literature Study ◽

Computer Gaming ◽

Digital Addiction ◽

The Impact ◽

Malaysian Adolescents

The advancement of technology has enabled powerful microprocessors to render high-quality graphics for computer gaming. Despite being intended for leisure purposes, several components of the games alongside the gamer’s environmental factors have resulted in digital addiction (DA) towards computer games such as massively multiplayer online games (MMOG). Excessive gaming among adolescents has various negative impacts on an individual. However, only a few researchers have addressed the impact of DA on physical health. Thus, the primary objective of this research is to study the impact of DA on physical health among Malaysian adolescents. This study focuses on Malaysian adolescents of ages 12–18 years old who are addicted to computer games, specifically the MMOG. The methodology used for the study involves focus group discussions (FGD) and extensive literature study. The FGD sessions have involved both medical experts and game experts. The outcome of FGD discussion is recorded and justified with the existing relevant literature from high-impact journals, theses, conferences, books, and reports. This paper provides evidence of five physical health impacts of DA associated with adolescents. The factors of DA, the addiction components existing in MMOG computer games, and the DA health risk assessment are presented in the results section. Based on the study, it is concluded that DA among Malaysian adolescents can cause various impacts on physical health such as obesity, back pain, and neck pain, orthopaedic/joint muscle, eyesight problem, hearing problem, as well as physical inactivity.

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