神经covid:与COVID-19相关的谵妄的药理学建议

IF 3.4 Q2 Medicine
Erica B. Baller M.D., M.S. , Charlotte S. Hogan M.D. , Mark A. Fusunyan M.D. , Ana Ivkovic M.D. , James W. Luccarelli M.D., D.Phil. , Elizabeth Madva M.D. , Mladen Nisavic M.D. , Nathan Praschan M.D., M.P.H. , Nadia V. Quijije M.D. , Scott R. Beach M.D. , Felicia A. Smith M.D.
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引用次数: 61

摘要

由严重急性呼吸系统综合征冠状病毒2 (SARS-CoV-2)引起的2019冠状病毒病(COVID-19)大流行已成为我们这一代人最大的健康威胁之一。很大一部分患者表现为谵妄和该疾病的神经精神后遗症。独特的检查结果和对治疗的反应已经确定。目的在本文中,我们寻求提供针对COVID-19患者谵妄的药物和治疗建议。方法查阅文献,回顾中东呼吸综合征和严重急性呼吸综合征冠状病毒等冠状病毒既往流行的神经精神并发症和治疗情况,以及新出现的有关COVID-19的文献。我们还召集了一个会诊联络精神科医生工作组,积极管理我院的COVID-19患者。最后,我们综合这些发现,为治疗这些患者的谵妄提供初步的药理学建议。结果谵妄常见于COVID-19检测阳性的患者,即使没有呼吸道症状。躁动、肌阵挛、食欲不振和痛症的发生率似乎更高。目前没有关于治疗COVID-19患者谵妄的数据。从一般谵妄治疗、中东呼吸综合征/严重急性呼吸综合征病例报告和我们的经验推断,已经收集了药物管理的初步建议。结论新型冠状病毒肺炎与神经精神症状相关。在这种情况下,低效抗精神病药和α -2肾上腺素能药物可能特别有用。进一步研究COVID-19的病理生理学将是制定更有针对性的治疗指南的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Neurocovid: Pharmacological Recommendations for Delirium Associated With COVID-19

Neurocovid: Pharmacological Recommendations for Delirium Associated With COVID-19

Neurocovid: Pharmacological Recommendations for Delirium Associated With COVID-19

Background

The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as one of the biggest health threats of our generation. A significant portion of patients are presenting with delirium and neuropsychiatric sequelae of the disease. Unique examination findings and responses to treatment have been identified.

Objective

In this article, we seek to provide pharmacologic and treatment recommendations specific to delirium in patients with COVID-19.

Methods

We performed a literature search reviewing the neuropsychiatric complications and treatments in prior coronavirus epidemics including Middle Eastern respiratory syndrome and severe acute respiratory syndrome coronaviruses, as well as the emerging literature regarding COVID-19. We also convened a work group of consultation-liaison psychiatrists actively managing patients with COVID-19 in our hospital. Finally, we synthesized these findings to provide preliminary pharmacologic recommendations for treating delirium in these patients.

Results

Delirium is frequently found in patients who test positive for COVID-19, even in the absence of respiratory symptoms. There appears to be a higher rate of agitation, myoclonus, abulia, and alogia. No data are currently available on the treatment of delirium in patients with COVID-19. Extrapolating from general delirium treatment, Middle Eastern respiratory syndrome/severe acute respiratory syndrome case reports, and our experience, preliminary recommendations for pharmacologic management have been assembled.

Conclusions

COVID-19 is associated with neuropsychiatric symptoms. Low-potency neuroleptics and alpha-2 adrenergic agents may be especially useful in this setting. Further research into the pathophysiology of COVID-19 will be key in developing more targeted treatment guidelines.

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来源期刊
Psychosomatics
Psychosomatics 医学-精神病学
CiteScore
3.20
自引率
0.00%
发文量
0
审稿时长
6-12 weeks
期刊介绍: The mission of Psychosomatics is to be the leading psychiatry journal focused on the care of patients with comorbid medical and psychiatric illnesses. The scope of Psychosomatics includes original research, review articles and clinical reports that address psychiatric aspects of medical illnesses and their management. Areas of particular interest include: the effect of co-morbid psychiatric conditions on the management of medical illness; the psychiatric management of patients with comorbid medical illness; educational content for physicians and others specializing in consultation-liaison (C-L) psychiatry; and, the provision of psychiatric services to medical populations, including integrated care.
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