A complication of coronavirus disease 2019: delirium
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ORIGINAL ARTICLE
A complication of coronavirus disease 2019: delirium Gabriele Cipriani1 · Sabrina Danti2 · Angelo Nuti1 · Cecilia Carlesi1 · Claudio Lucetti1 · Mario Di Fiorino3 Received: 22 April 2020 / Accepted: 2 June 2020 © Belgian Neurological Society 2020
Abstract COVID-19 is predominantly a respiratory disease. However, some cases exhibit other features including Central Nervous System symptoms. In the older adult, COVID-19 may present with atypical symptoms, including delirium and its complications. The objective of this study is to describe the relationship between the new type of coronavirus infection and delirium. Systematic research (Cochrane Library and PubMed) was carried out (only upper time limit: April 2020). Publications found through this indexed search were reviewed and manually screened to identify relevant studies. Search terms used included “COVID-19, Delirium, Dementia, Intensive Care Unit”. We manually added articles identified through other sources (i.e., key journals). Older people are at the greatest risk from COVID-19. If infected, they may present delirium. Moreover, it is not exclusive to older people. Delirium is not inevitable; rather, it is preventable. Delirium prevention programs are even more crucial in the era of COVID-19 and cannot be allowed to wither despite the challenges of integrating delirium prevention with COVID-19 care. An acute change in condition, behaviour, or mental status should prompt a delirium screen. As regards the treatment, it is advisable to use non-pharmacological interventions first where possible. Medication may be needed for patients with agitation where there is intractable distress or high risk to self/others. Keywords COVID-19 · Delirium · Dementia · Intensive-care unit
Introduction Coronavirus disease 2019 (COVID-19), first reported in Wuhan, a city in the Hubei Province of China, in late December 2019 [1], is characterized by severe acute respiratory syndrome designated as SARS-CoV-2. It has affected many people, rapidly spreading, and resulting in a pandemic in a short period. The novel coronavirus was identified as a non-segmented, positive-sense RNA virus [2]. In January 2020, ACE2 was identified as the functional receptor for SARS-CoV-2, which is present in multiple human organs, including the nervous system and skeletal muscles [3].
All co-authors have contributed significantly confirming their agreement to this submission. * Gabriele Cipriani [email protected] 1
Neurology Unit, Versilia Hospital, via Aurelia, Lido di Camaiore, 55043 Lucca, Lu, Italy
2
Clinical and Health Psychology Unit, Hospital of Pontedera, Pontedera, Italy
3
Psychiatry Unit, Versilia Hospital, Lido di Camaiore, Italy
While the primary target of COVID-19 is the lungs, it does not stop there. Other organs such as the heart, liver, kidneys, and brain could also be damaged. Central nervous system symptoms (CNS) were the main form of neurologic injury in patients with COVID-19 [4]. It is not clear whether these neurologic syndromes are a direct cause of
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