Possible Psychiatric and Neuropsychiatric Complications of COVID-19: A Systematic Review and Meta-analysis
|
|
Dr. Emma Hamid My name is Emma Hamid, and I am a PGY1 psychiatry resident at the University of Saskatchewan. I grew up in Calgary and obtained a Bachelor of Science degree from the University of Calgary. I attended medical school at University College Cork in Ireland and graduated in 2020. Living in Ireland was one of the best and most exciting times in my life and I was able to pursue a career I love while learning so much about myself. I am now back home and really enjoying my first year of Psychiatry residency in Saskatoon. I particularly am enjoying how I am growing as a young physician and learning new skills. What attracted me most to psychiatry is the opportunity to make a significant impact in the lives of my patients, as mental health permeates every aspect of a person’s life. It is tough at times but hugely rewarding and I am really excited to see where my career takes me. Some of my interests include yoga, running, and skiing to stay active. |
Learning Objectives:
1. List the psychiatric diagnoses commonly associated with acute and chronic Coronavirus infection;
2. List possible mechanism of the manifestation of psychiatric/neuropsychiatric illness after SARS/MERS infection; and
3. Describe some of the limitations of this study.
Abstract:
The COVID-19 pandemic has posed a significant challenge to the world’s medical infrastructure. The sheer number of global infections infers that there will be a significant psychiatric burden related to COVID-19 infection. There is currently little data describing the short- and long-term psychiatric complications of this virus. However, related pandemics including SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory syndrome) were shown to have both psychiatric and neuropsychiatric complications (1). This abstract will summarise a Systematic Review and Meta-Analysis published in the Lancet Journal of Psychiatry. This paper focused on previous literature published from past pandemics, with the goal of drawing comparisons and possible inferences about the acute and chronic psychiatric complications of severe COVID-19 infection.
This paper reviewed 72 studies which described psychiatric and neuropsychiatric sequelae of Coronavirus infection in the acute and chronic phases. Acute manifestations comprised mainly of delirium, whereas long term sequelae included PTSD, depression, anxiety and fatigue. Over one in six patients infected suffered from mental fog consisting of reduced concentration and memory, sleep disturbance, traumatic memories, and reduced emotional regulation (1). Eliciting factors may include CNS viral infiltration, inflammation, viral hyper-coagulability, hypoxia, as well as isolation. The majority of studies reviewed pertained to hospitalised patients, representing a significant limitation of the review in terms of selection bias. Additionally, few studies collected data on previously existing mental illness or use comparison groups.
Literature References:
1. Rogers, J. P., Chesney, E., Oliver, D., Pollak, T. A., McGuire, P., Fusar-Poli, P., ... & David, A. S. (2020). Psychiatric and neuropsychiatric presentations associated with severe coronavirus infections: a systematic review and meta-analysis with comparison to the COVID-19 pandemic. The Lancet Psychiatry, 7(7), 611-627.
2. Pfefferbaum, B., & North, C. S. (2020). Mental health and the Covid-19 pandemic. New England Journal of Medicine, 383(6), 510512.
3. Gasmi, A., Tippairote, T., Mujawdiya, P. K., Benahmed, A. G., Menzel, A., Dadar, M., & Bjørklund, G. (2020). Neurological Involvements of SARS-CoV2 Infection. Molecular Neurobiology, 1-6.