Review Highlights Neuropsychiatric Presentations of COVID-19

Evidence presented for delirium during COVID-19, post-illness neuropsychiatric consequences for SARS, MERS
doctor examining his patient wearing oxygen mask
doctor examining his patient wearing oxygen mask

WEDNESDAY, May 20, 2020 (HealthDay News) -- COVID-19 may cause delirium in some patients, according to a review published online May 18 in The Lancet Psychiatry.

Jonathan P. Rogers, M.B., B.Chir., from University College London, and colleagues conducted a systematic review and meta-analysis to examine the psychiatric and neuropsychiatric presentations of severe acute respiratory syndrome (SARS), starting in 2002, Middle East respiratory syndrome (MERS) starting in 2012, and COVID-19. Data from 65 peer-reviewed studies and seven preprints were included, with 3,559 coronavirus cases.

The researchers found that common symptoms among patients admitted to the hospital for SARS or MERS included confusion (27.9 percent), depressed mood (32.6 percent), anxiety (35.7 percent), impaired memory (34.1 percent), and insomnia (41.9 percent) during acute illness. In the post-illness stage, the point prevalences of posttraumatic stress disorder, depression, and anxiety disorders were 32.2, 14.9, and 14.8 percent, respectively. On examination of data for patients with COVID-19, there was evidence for delirium (confusion and agitation in 65 and 69 percent, respectively, of intensive care unit patients in one study; altered consciousness in 21 percent of patients in another study). In one study, one-third of patients with COVID-19 had a dysexecutive syndrome at discharge. Two reports of hypoxic encephalopathy and one of encephalitis were noted at the time of writing.

"This review suggests, first, that most people do not suffer from a psychiatric disorder following coronavirus infection, and second, that so far there is little to suggest that common neuropsychiatric complications beyond short-term delirium are a feature," the authors write.

Two authors disclosed financial ties to the biopharmaceutical industry.

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