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Neurocovid: Pharmacological Recommendations for Delirium Associated With
COVID-19
#MMPMID32828569
Baller EB
; Hogan CS
; Fusunyan MA
; Ivkovic A
; Luccarelli JW
; Madva E
; Nisavic M
; Praschan N
; Quijije NV
; Beach SR
; Smith FA
Psychosomatics
2020[Nov]; 61
(6
): 585-596
PMID32828569
show ga
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.
|Adrenergic alpha-2 Receptor Agonists/*therapeutic use
[MESH]
free
free
free
