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Rahman A, Russell M, Zheng W, Eckrich D, Ahmed I. SARS-CoV-2 infection is associated with an increase in new diagnoses of schizophrenia spectrum and psychotic disorder: A study using the US national COVID cohort collaborative (N3C). PLoS One 2024; 19:e0295891. [PMID: 38814888 PMCID: PMC11139284 DOI: 10.1371/journal.pone.0295891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 03/13/2024] [Indexed: 06/01/2024] Open
Abstract
Amid the ongoing global repercussions of SARS-CoV-2, it is crucial to comprehend its potential long-term psychiatric effects. Several recent studies have suggested a link between COVID-19 and subsequent mental health disorders. Our investigation joins this exploration, concentrating on Schizophrenia Spectrum and Psychotic Disorders (SSPD). Different from other studies, we took acute respiratory distress syndrome (ARDS) and COVID-19 lab-negative cohorts as control groups to accurately gauge the impact of COVID-19 on SSPD. Data from 19,344,698 patients, sourced from the N3C Data Enclave platform, were methodically filtered to create propensity matched cohorts: ARDS (n = 222,337), COVID-19 positive (n = 219,264), and COVID-19 negative (n = 213,183). We systematically analyzed the hazard rate of new-onset SSPD across three distinct time intervals: 0-21 days, 22-90 days, and beyond 90 days post-infection. COVID-19 positive patients consistently exhibited a heightened hazard ratio (HR) across all intervals [0-21 days (HR: 4.6; CI: 3.7-5.7), 22-90 days (HR: 2.9; CI: 2.3 -3.8), beyond 90 days (HR: 1.7; CI: 1.5-1.)]. These are notably higher than both ARDS and COVID-19 lab-negative patients. Validations using various tests, including the Cochran Mantel Haenszel Test, Wald Test, and Log-rank Test confirmed these associations. Intriguingly, our data indicated that younger individuals face a heightened risk of SSPD after contracting COVID-19, a trend not observed in the ARDS and COVID-19 negative groups. These results, aligned with the known neurotropism of SARS-CoV-2 and earlier studies, accentuate the need for vigilant psychiatric assessment and support in the era of Long-COVID, especially among younger populations.
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Affiliation(s)
- Asif Rahman
- Department of Industrial & Management Systems Engineering, West Virginia University, Morgantown, WV, United States of America
| | - Michael Russell
- School of Medicine, West Virginia University, Morgantown, WV, United States of America
| | - Wanhong Zheng
- School of Medicine, West Virginia University, Morgantown, WV, United States of America
| | - Daniel Eckrich
- Nemours Children’s Health, Jacksonville, FL, United States of America
| | - Imtiaz Ahmed
- Department of Industrial & Management Systems Engineering, West Virginia University, Morgantown, WV, United States of America
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Sun Z, Zhang L, Wang R, Wang Z, Liang X, Gao J. Identification of shared pathogenetic mechanisms between COVID-19 and IC through bioinformatics and system biology. Sci Rep 2024; 14:2114. [PMID: 38267482 PMCID: PMC10808107 DOI: 10.1038/s41598-024-52625-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/22/2024] [Indexed: 01/26/2024] Open
Abstract
COVID-19 increased global mortality in 2019. Cystitis became a contributing factor in SARS-CoV-2 and COVID-19 complications. The complex molecular links between cystitis and COVID-19 are unclear. This study investigates COVID-19-associated cystitis (CAC) molecular mechanisms and drug candidates using bioinformatics and systems biology. Obtain the gene expression profiles of IC (GSE11783) and COVID-19 (GSE147507) from the Gene Expression Omnibus (GEO) database. Identified the common differentially expressed genes (DEGs) in both IC and COVID-19, and extracted a number of key genes from this group. Subsequently, conduct Gene Ontology (GO) functional enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis on the DEGs. Additionally, design a protein-protein interaction (PPI) network, a transcription factor gene regulatory network, a TF miRNA regulatory network, and a gene disease association network using the DEGs. Identify and extract hub genes from the PPI network. Then construct Nomogram diagnostic prediction models based on the hub genes. The DSigDB database was used to forecast many potential molecular medicines that are associated with common DEGs. Assess the precision of hub genes and Nomogram models in diagnosing IC and COVID-19 by employing Receiver Operating Characteristic (ROC) curves. The IC dataset (GSE57560) and the COVID-19 dataset (GSE171110) were selected to validate the models' diagnostic accuracy. A grand total of 198 DEGs that overlapped were found and chosen for further research. FCER1G, ITGAM, LCP2, LILRB2, MNDA, SPI1, and TYROBP were screened as the hub genes. The Nomogram model, built using the seven hub genes, demonstrates significant utility as a diagnostic prediction model for both IC and COVID-19. Multiple potential molecular medicines associated with common DEGs have been discovered. These pathways, hub genes, and models may provide new perspectives for future research into mechanisms and guide personalised and effective therapeutics for IC patients infected with COVID-19.
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Affiliation(s)
- Zhenpeng Sun
- Department of Urology, Qingdao Municipal Hospital, No.5, Donghai Middle Road, Shinan District, Qingdao, 266001, Shandong, China
- Qingdao Medical College, Qingdao University, Qingdao, China
| | - Li Zhang
- Institute of Systems Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
- Suzhou Institute of Systems Medicine, Suzhou, China
| | - Ruihong Wang
- Department of Outpatient, Qingdao Central Hospital, Qingdao University, Qingdao, China
| | - Zheng Wang
- Zhucheng People's Hospital, Zhucheng, China
| | - Xin Liang
- Department of Urology, Qingdao Municipal Hospital, No.5, Donghai Middle Road, Shinan District, Qingdao, 266001, Shandong, China
| | - Jiangang Gao
- Department of Urology, Qingdao Municipal Hospital, No.5, Donghai Middle Road, Shinan District, Qingdao, 266001, Shandong, China.
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3
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Klein HC, Guest PC, Dobrowolny H, Steiner J. Inflammation and viral infection as disease modifiers in schizophrenia. Front Psychiatry 2023; 14:1231750. [PMID: 37850104 PMCID: PMC10577328 DOI: 10.3389/fpsyt.2023.1231750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 09/12/2023] [Indexed: 10/19/2023] Open
Abstract
Numerous studies have now implicated a role for inflammation in schizophrenia. However, many aspects surrounding this aspect of the disease are still controversial. This controversy has been driven by conflicting evidence on the role of both pro-and anti-inflammatory factors and by often contentious findings concerning cytokine and immune cell profiles in the central nervous system and periphery. Current evidence supports the point that interleukin-6 is elevated in CSF, but does not support activation of microglia, resident macrophage-like cells in the brain. Furthermore, the mechanisms involving transit of the peripheral immune system factors across the blood brain barrier to central parenchyma have still not been completely elucidated. This process appears to involve perivascular macrophages and accompanying dendritic cells retained in the parenchyma by the chemokine and cytokine composition of the surrounding milieu. In addition, a number of studies have shown that this can be modulated by infection with viruses such as herpes simplex virus type I which may disrupt antigen presentation in the perivascular space, with long-lasting consequences. In this review article, we discuss the role of inflammation and viral infection as potential disease modifiers in schizophrenia. The primary viral hit may occur in the fetus in utero, transforming the immune response regulatory T-cells or the virus may secondarily remain latent in immune cells or neurons and modify further immune responses in the developing individual. It is hoped that unraveling this pathway further and solidifying our understanding of the pathophysiological mechanisms involved will pave the way for future studies aimed at identification and implementation of new biomarkers and drug targets. This may facilitate the development of more effective personalized therapies for individuals suffering with schizophrenia.
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Affiliation(s)
- Hans C. Klein
- Department of Nuclear Medicine and Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Research and Education Department Addiction Care Northern Netherlands, Groningen, Netherlands
| | - Paul C. Guest
- Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Laboratory of Translational Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Laboratory of Neuroproteomics, Department of Biochemistry and Tissue Biology, Institute of Biology, University of Campinas (UNICAMP), Campinas, Brazil
| | - Henrik Dobrowolny
- Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Laboratory of Translational Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | - Johann Steiner
- Department of Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Laboratory of Translational Psychiatry, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
- Center for Health and Medical Prevention (CHaMP), Magdeburg, Germany
- German Center for Mental Health (DZPG), Center for Intervention and Research on Adaptive and Maladaptive Brain Circuits Underlying Mental Health (C-I-R-C), Halle-Jena-Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Magdeburg, Germany
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4
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Hui CLM, Wong CCL, Chan EWT, Suen YN, Chan SKW, Lee EHM, Chang WC, Chen EYH. COVID-19 exposure and psychosis: A comparison of clinical, functional, and cognitive profiles in remitted patients with psychosis. Psychiatry Res 2023; 328:115487. [PMID: 37769485 DOI: 10.1016/j.psychres.2023.115487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/14/2023] [Accepted: 09/15/2023] [Indexed: 10/03/2023]
Abstract
The impact of Coronavirus Disease 2019 (COVID-19) on psychiatric care in remitted patients with first-episode psychosis (FEP) remains unknown. This study compared the demographic, clinical, functional, and cognitive profiles of patients recruited before and during the pandemic. The results showed that COVID patients were significantly older, smokers, alcohol users, experienced more stressors, with better functioning than pre-COVID patients. The former also had fewer severe negative and general psychopathological symptoms, more impaired insight, poorer medication compliance, and worse cognitive performance. Our findings highlighted a timely need to improve awareness into the illness and treatment in FEP patients experiencing pandemic related stressors.
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Affiliation(s)
- Christy Lai Ming Hui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China.
| | - Charlie Cheuk Lam Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Evie Wai Ting Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Yi Nam Suen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Sherry Kit Wa Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Edwin Ho Ming Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Wing Chung Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Eric Yu Hai Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region of China
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5
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McAlpine LS, Lifland B, Check JR, Angarita GA, Ngo TT, Chen P, Dandekar R, Alvarenga BD, Browne WD, Pleasure SJ, Wilson MR, Spudich SS, Farhadian SF, Bartley CM. Anti-SARS-CoV-2 and Autoantibody Profiling of a COVID-19 Patient With Subacute Psychosis Who Remitted After Treatment With Intravenous Immunoglobulin. Biol Psychiatry 2023; 93:e25-e29. [PMID: 36481066 PMCID: PMC9722219 DOI: 10.1016/j.biopsych.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 09/07/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Lindsay S McAlpine
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
| | - Brooke Lifland
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Joseph R Check
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Gustavo A Angarita
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Thomas T Ngo
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California
| | - Peixi Chen
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Ravi Dandekar
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Bonny D Alvarenga
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Weston D Browne
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Samuel J Pleasure
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Michael R Wilson
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Neurology, University of California, San Francisco, California
| | - Serena S Spudich
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
| | - Shelli F Farhadian
- Department of Internal Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut
| | - Christopher M Bartley
- Weill Institute for Neurosciences, University of California, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California.
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Ayesa-Arriola R, Castro Quintas Á, Ortiz-García de la Foz V, Miguel Corredera M, San Martín González N, Murillo-García N, Neergaard K, Fañanás Saura L, de las Cuevas-Terán I. Exploring the impact of COVID-19 on newborn neurodevelopment: a pilot study. Sci Rep 2023; 13:2983. [PMID: 36805488 PMCID: PMC9941470 DOI: 10.1038/s41598-023-29680-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 02/08/2023] [Indexed: 02/22/2023] Open
Abstract
The COVID-19 pandemic can seize the opportunity to explore the hypothesis of prenatal exposure to viral infections increases the risk for neurodevelopmental disorders. Advancing our knowledge in this regard would improve primary prevention of mental disorders in children. For this pilot study, six-week-old infants born to mothers exposed (n = 21) or unexposed (n = 21) to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were assessed in Santander-Cantabria (Spain) using the Neonatal Behavioral Assessment Scale (NBAS). Groups comparisons were performed to explore the effects that infection and timing of exposure (in terms of the three trimesters of pregnancy). The infants' competencies and performances on the NBAS were generally similar in the exposed and unexposed to SARS-CoV-2 groups. The most significant difference found was a less optimally response to cuddliness (item on the state regulation domain) particularly in infants born to mothers exposed in the third trimester of pregnancy, and in pull-to-sit (item on the motor system domain). Although our interpretations must be careful, these preliminary results highlight the possible association between prenatal SARS-CoV-2 exposure and poorer development in motor skills and infant interactive behavior. Further longitudinal studies are needed to explore these relationships and disentangle the biological mechanisms implicated.
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Affiliation(s)
- Rosa Ayesa-Arriola
- University of Cantabria, Santander, Spain. .,Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain. .,Mental Illnesses Research Unit, Marqués de Valdecilla Research Institute, IDIVAL, Santander, Spain.
| | - Águeda Castro Quintas
- grid.5841.80000 0004 1937 0247Department of Evolutionary Biology, Ecology and Environmental Sciences (BEECA), Faculty of Biology, University of Barcelona, Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain ,grid.469673.90000 0004 5901 7501Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Víctor Ortiz-García de la Foz
- grid.469673.90000 0004 5901 7501Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain ,grid.484299.a0000 0004 9288 8771Mental Illnesses Research Unit, Marqués de Valdecilla Research Institute, IDIVAL, Santander, Spain
| | - Margarita Miguel Corredera
- grid.484299.a0000 0004 9288 8771Mental Illnesses Research Unit, Marqués de Valdecilla Research Institute, IDIVAL, Santander, Spain
| | - Nerea San Martín González
- grid.5841.80000 0004 1937 0247Department of Evolutionary Biology, Ecology and Environmental Sciences (BEECA), Faculty of Biology, University of Barcelona, Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain
| | - Nancy Murillo-García
- grid.7821.c0000 0004 1770 272XUniversity of Cantabria, Santander, Spain ,grid.484299.a0000 0004 9288 8771Mental Illnesses Research Unit, Marqués de Valdecilla Research Institute, IDIVAL, Santander, Spain
| | - Karl Neergaard
- grid.484299.a0000 0004 9288 8771Mental Illnesses Research Unit, Marqués de Valdecilla Research Institute, IDIVAL, Santander, Spain
| | - Lourdes Fañanás Saura
- grid.5841.80000 0004 1937 0247Department of Evolutionary Biology, Ecology and Environmental Sciences (BEECA), Faculty of Biology, University of Barcelona, Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Spain ,grid.469673.90000 0004 5901 7501Centro Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Isabel de las Cuevas-Terán
- grid.7821.c0000 0004 1770 272XUniversity of Cantabria, Santander, Spain ,grid.411325.00000 0001 0627 4262Neonatal Unit, Pediatric Service, University Hospital Marqués de Valdecilla, Santander, Spain
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7
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New-Onset Hyperreligiosity, Demonic Hallucinations, and Apocalyptic Delusions following COVID-19 Infection. Case Rep Psychiatry 2023; 2023:9792099. [PMID: 36819980 PMCID: PMC9938787 DOI: 10.1155/2023/9792099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 12/08/2022] [Accepted: 01/18/2023] [Indexed: 02/13/2023] Open
Abstract
Background Neuropsychiatric sequelae of COVID-19 have been documented, including delusions, hallucinations, agitation, and disorganized behavior. Although the mechanisms for these symptoms remain unclear, there has been an increasing body of literature suggesting a correlation between COVID-19 infection and psychosis. Here, we illustrate the case of a 34-year-old female with no previous psychiatric history who contracted COVID-19 and subsequently developed severe symptoms of psychosis. After presenting to the emergency department with one month of worsening mood, auditory hallucinations, intrusive thoughts, and hyperreligiosity, she was admitted to the inpatient psychiatric unit. The patient was treated with multiple antipsychotic medications and was discharged in stable condition with resolution of her auditory hallucinations; however, her delusions, hyperreligiosity, and negative psychotic symptoms persisted, resulting in a second inpatient psychiatric admission eight days after discharge, during which she again did not reach full remission. Objectives With this information, we hope to increase awareness of COVID-induced psychosis and further discuss the relationship between COVID-19 infection and neuropsychiatric symptoms. Conclusions Although there has been increasing research about the COVID-19 pandemic, there is much to be elucidated regarding the neuropsychiatric symptoms related to these infections. Similar to previous studies, our case describes a patient with no previous psychiatric history who developed severe psychotic symptoms after COVID-19 infection and was admitted to the inpatient psychiatric unit. These symptoms resulting from infection can be severe or debilitating for the patient. Therefore, physicians should be aware of these potential neuropsychiatric sequelae when treating patients with active COVID-19 infections, and treatment with antipsychotics or acute inpatient psychiatric admission should be considered.
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Ellini S, Romdhane IB, Bougacha D, Abassi A, Cheour M, Damak R. COVID-19 induced psychosis: A case report. Psychiatry Res 2023; 320:115009. [PMID: 36577231 PMCID: PMC9742060 DOI: 10.1016/j.psychres.2022.115009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 12/09/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Sana Ellini
- Department of adult psychiatry "Ibn Omrane", The University psychiatric Hospital Razi, Manouba, Tunis. Tunisia; Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.
| | - Imen Ben Romdhane
- Department of adult psychiatry "Ibn Omrane", The University psychiatric Hospital Razi, Manouba, Tunis. Tunisia,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Dhouha Bougacha
- Department of adult psychiatry "Ibn Omrane", The University psychiatric Hospital Razi, Manouba, Tunis. Tunisia,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Ameni Abassi
- Department of adult psychiatry "Ibn Omrane", The University psychiatric Hospital Razi, Manouba, Tunis. Tunisia,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Majda Cheour
- Department of adult psychiatry "Ibn Omrane", The University psychiatric Hospital Razi, Manouba, Tunis. Tunisia,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Rahma Damak
- Department of adult psychiatry "Ibn Omrane", The University psychiatric Hospital Razi, Manouba, Tunis. Tunisia,Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
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First-episode psychotic disorders in the wake of the COVID-19 pandemic: a descriptive review of casereports. Acta Neuropsychiatr 2022; 34:289-310. [PMID: 35357298 DOI: 10.1017/neu.2022.11] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Since the onset of COVID-19 pandemic, many case reports and case series dealt with new-onset psychotic disorders in patients either infected with SARS-CoV-2 or thematically linked to the pandemic, but without an infection. Our aim was to provide a comprehensive collection of these reports to illustrate the nature of these psychoses. METHODS We conducted a literature search in MEDLINE, Embase, PsycINFO, using search terms regarding first-episode psychotic disorders in the context of corona. RESULTS 96 case reports or case series covering 146 patients (62 without and 84 with SARS-CoV-2 infection) were found. Compared to patients without infection, patients with infection showed significantly more often visual hallucinations (28.6% vs 8.1%), confusion (36.9% vs 11.3%), an acute onset of illness (88.5% vs 59.6%) and less often depression (13.1% vs 35.5%) and a delusional content related to the pandemic (29.5% vs 78.3%). Both groups had an equally favourable outcome with a duration of psychosis ≤2 weeks in half and full remission in two-thirds of patients. In patients with infection, signs of inflammation were reported in 78.3% and increased CRP in 58.6%. While reports on patients with infection are continuously published, no report about patients without infection was found after July 2020. CONCLUSION Cases without infection were considered reactive and originated all from the first wave of the corona pandemic. In cases with infection, inflammation was considered as the main pathogenetic factor but was not found in all patients. Diagnosis was impeded by the overlap of psychosis with delirium.
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10
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Huang W, Zhu L, Wu M, Teng L, Zhang M, Song W. Effects of acupuncture combined with medication on patients with COVID-19 complicated with bipolar disorder: A protocol of systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31474. [PMID: 36397416 PMCID: PMC9665892 DOI: 10.1097/md.0000000000031474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is growing evidence that coronavirus disease 2019 (COVID-19) can trigger acute episodes of mood disorders or psychotic symptoms. Reports on the treatment of COVID-19-related bipolar disorder (BD) are limited. Our study aimed to investigate the potential for new or recurrent BD due to COVID-19. We qualitatively evaluate clinical treatments (acupuncture combined with medication) and any potential pathophysiological links between infection and BD. METHODS We searched Embase, PubMed, Cochrane Library, Web of Science and MEDLINE (via Web of Science), Scopus, Chinese Biomedical Literature Database (CBM), Chinese National Knowledge Infrastructure Database, and the Wanfang Database from December 1, 2019, to September 15, 2022, to identify all articles on acupuncture combined with drugs used to treat COVID-19 complicated with bipolar disorders. Two researchers will screen the articles and extract the relevant information. RESULTS The results will provide a systematic overview of the current evidence on the use of acupuncture combined with drug therapy to treat COVID-19 complicated with bipolar disorder. CONCLUSION The conclusions of this study will help clarify the effects of acupuncture combined with drug therapy on patients with COVID-19-related BD.
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Affiliation(s)
- Wenjing Huang
- Heilongjiang Administration of Traditional Chinese Medicine, Harbin, China
| | - Luwen Zhu
- The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Minmin Wu
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Lili Teng
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Mei Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Wenjing Song
- Heilongjiang University of Chinese Medicine, Harbin, China
- * Correspondence: Wenjing Song, Heilongjiang University of Chinese Medicine, Harbin 150000, China (e-mail: )
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11
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Desai SS, Nguyen AL, Bernstein GA. Letter to editor: Case report of long COVID-19 with psychosis in a child. Psychiatry Res 2022; 316:114743. [PMID: 35940086 PMCID: PMC9310377 DOI: 10.1016/j.psychres.2022.114743] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/18/2022] [Accepted: 07/21/2022] [Indexed: 11/29/2022]
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12
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Russo M, Calisi D, De Rosa MA, Evangelista G, Consoli S, Dono F, Santilli M, Gambi F, Onofrj M, Di Giannantonio M, Parruti G, Sensi SL. COVID-19 and first manic episodes: a systematic review. Psychiatry Res 2022; 314:114677. [PMID: 35716481 PMCID: PMC9181635 DOI: 10.1016/j.psychres.2022.114677] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 06/06/2022] [Accepted: 06/08/2022] [Indexed: 01/07/2023]
Abstract
Sars-CoV-2 is a respiratory virus that can access the central nervous system, as indicated by the presence of the virus in patients' cerebrospinal fluid and the occurrence of several neurological syndromes during and after COVID-19. Growing evidence indicates that Sars-CoV-2 can also trigger the acute onset of mood disorders or psychotic symptoms. COVID-19-related first episodes of mania, in subjects with no known history of bipolar disorder, have never been systematically analyzed. Thus, the present study assesses a potential link between the two conditions. This systematic review analyzes cases of first appearance of manic episodes associated with COVID-19. Clinical features, pharmacological therapies, and relationships with pre-existing medical conditions are also appraised. Medical records of twenty-three patients fulfilling the current DSM-5 criteria for manic episode were included. Manic episodes started, on average, after 12.71±6.65 days from the infection onset. Psychotic symptoms were frequently reported. 82.61% of patients exhibited delusions, whereas 39.13% of patients presented hallucinations. A large discrepancy in the diagnostic workups was observed. Mania represents an underestimated clinical presentation of COVID-19. Further studies should focus on the pathophysiological substrates of COVID-19-related mania and pursue appropriate and specific diagnostic and therapeutic workups.
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Affiliation(s)
- Mirella Russo
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy,CAST - Center for Advanced Studies and Technology, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Dario Calisi
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Matteo A. De Rosa
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Giacomo Evangelista
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Stefano Consoli
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Fedele Dono
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy,CAST - Center for Advanced Studies and Technology, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Matteo Santilli
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Francesco Gambi
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy,CAST - Center for Advanced Studies and Technology, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Marco Onofrj
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy,CAST - Center for Advanced Studies and Technology, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - Giustino Parruti
- Department of Infectious Diseases, Azienda Sanitaria Locale (AUSL) di Pescara, Pescara, Italy
| | - Stefano L. Sensi
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy,CAST - Center for Advanced Studies and Technology, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy,ITAB - Institute of Advanced Biomedical Technology, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy,Institute for Mind Impairments and Neurological Disorders-iMIND, University of California, Irvine, Irvine, CA, United States,Corresponding author at: Department of Neurosciences, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
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13
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DeLisi LE. Commentary on whether progressive brain change underlies the pathology of schizophrenia: Should this even be debated? Schizophr Res 2022; 244:18-20. [PMID: 35567869 DOI: 10.1016/j.schres.2022.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Lynn E DeLisi
- Attending Psychiatrist and Director of Faculty Affairs, Department of Psychiatry, Cambridge Health Alliance, Professor of Psychiatry, Harvard Medical School, Cambridge, MA, United States of America.
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14
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Psychotic disorders amid the COVID-19 pandemic: a consideration of risks and impacts. Curr Opin Psychiatry 2022; 35:140-145. [PMID: 35125397 DOI: 10.1097/yco.0000000000000784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic has had a severe and widespread global impact but particularly for those with psychosis. This review summarizes recent evidence on the relationship between the COVID-19 pandemic and psychotic disorders, highlighting the risks faced by these individuals including the negative impacts on treatment services, complications from contracting COVID-19, and the acceptability of digital interventions. RECENT FINDINGS Mortality, morbidity, and infection outcomes are among the worst for individuals with psychotic disorders. Presentation rates for psychotic disorders are elevated at emergency departments compared with before the COVID-19 pandemic; demand for inpatient services has increased, and there have been complications in access because of pandemic restrictions. COVID-19 related stressors have led to the exacerbation and incidence of psychotic symptoms among individuals with and without preexisting psychotic diagnoses. Digital interventions may be an acceptable method for maintaining patient contact and treatment during extended isolation. SUMMARY More data is needed on the longitudinal trajectory for psychotic symptoms post-COVID-19 infection and pandemic restrictions to better support individuals with psychotic disorders. Development of a long-term pandemic management plan is needed to monitor and support psychiatric health across the population.
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15
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Hu H, Tang N, Zhang F, Li L, Li L. Bioinformatics and System Biology Approach to Identify the Influences of COVID-19 on Rheumatoid Arthritis. Front Immunol 2022; 13:860676. [PMID: 35464423 PMCID: PMC9021444 DOI: 10.3389/fimmu.2022.860676] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 03/16/2022] [Indexed: 02/05/2023] Open
Abstract
Background Severe coronavirus disease 2019 (COVID -19) has led to a rapid increase in mortality worldwide. Rheumatoid arthritis (RA) was a high-risk factor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, whereas the molecular mechanisms underlying RA and CVOID-19 are not well understood. The objectives of this study were to analyze potential molecular mechanisms and identify potential drugs for the treatment of COVID-19 and RA using bioinformatics and a systems biology approach. Methods Two Differentially expressed genes (DEGs) sets extracted from GSE171110 and GSE1775544 datasets were intersected to generate common DEGs, which were used for functional enrichment, pathway analysis, and candidate drugs analysis. Results A total of 103 common DEGs were identified in the two datasets between RA and COVID-19. A protein-protein interaction (PPI) was constructed using various combinatorial statistical methods and bioinformatics tools. Subsequently, hub genes and essential modules were identified from the PPI network. In addition, we performed functional analysis and pathway analysis under ontological conditions and found that there was common association between RA and progression of COVID-19 infection. Finally, transcription factor-gene interactions, protein-drug interactions, and DEGs-miRNAs coregulatory networks with common DEGs were also identified in the datasets. Conclusion We successfully identified the top 10 hub genes that could serve as novel targeted therapy for COVID-19 and screened out some potential drugs useful for COVID-19 patients with RA.
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Affiliation(s)
- Huan Hu
- Department of Rheumatology and Immunology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China.,Clinical Medical College, Guizhou Medical University, Guiyang, China
| | - Nana Tang
- Medical Intensive Care Unit, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Facai Zhang
- Department of Urology/Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Li Li
- Medical Intensive Care Unit, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Long Li
- Department of Rheumatology and Immunology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
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16
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The Impact of the COVID-19 Virus Pandemic on the Incidence of First Psychotic Spectrum Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073781. [PMID: 35409462 PMCID: PMC8997854 DOI: 10.3390/ijerph19073781] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/20/2022] [Accepted: 03/09/2022] [Indexed: 02/05/2023]
Abstract
The effects of COVID-19 on the human body are not yet understood enough. Medical history provides information on cases of psychiatric symptoms during viral infections in the 20th century, such as the influenza pandemic. Currently, it is observed that there is an increasing number of new psychiatric disorders in previously healthy individuals. In addition, because of the decreased amount of reporting to health care providers, including psychiatrists, many physicians suggest that the number of neuropsychiatric disorders may be underestimated. In this paper, we review available studies on the occurrence of first-time psychotic spectrum disorder (PSD) in individuals related to SARS-CoV-2 infection. The reviewed studies suggest that first-time psychotic disorder in COVID-19 patients is statistically significantly more frequent compared to influenza, as well as to other respiratory infections. The emergence of new PSDs is explained by direct neurotropism of the virus on the one hand and by immunological mechanisms on the other. The main conclusions of this review should be treated with caution, and future research on this topic is needed. The authors recognize the particular need to develop standardized laboratory panels that include inflammatory markers (IL-6, TNF-α), cerebrospinal fluid (CSF) testing, and SARS-CoV-2 antibody assays to entirely understand the etiology of neuropsychiatric complications of SARS-CoV-2 infections and the pandemic itself. In addition, public health efforts are required to promote mental health, especially during COVID-19.
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17
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Exacerbation of psychosis risk during the COVID-19 pandemic: The disproportionate impact on the lower income population. Psychiatry Res 2022; 307:114319. [PMID: 34864230 PMCID: PMC8628604 DOI: 10.1016/j.psychres.2021.114319] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/18/2021] [Accepted: 11/26/2021] [Indexed: 12/18/2022]
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18
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Russo M, Consoli S, De Rosa M, Calisi D, Dono F, Carrarini C, Onofrj M, De Angelis M, Sensi S. A case of Sars-Cov-2-related mania with prominent psychosis>. Psychiatry Res 2021; 306:114266. [PMID: 34781110 PMCID: PMC8562037 DOI: 10.1016/j.psychres.2021.114266] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 10/19/2021] [Accepted: 10/31/2021] [Indexed: 01/15/2023]
Affiliation(s)
- M. Russo
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - S. Consoli
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - M.A. De Rosa
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - D. Calisi
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - F. Dono
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - C. Carrarini
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - M. Onofrj
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - M.V. De Angelis
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - S.L. Sensi
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy,Center of Advanced Studies and Technology, “G. d'Annunzio” University of Chieti-Pescara, Chieti, Italy,Institute for Mind Impairments and Neurological Disorders (IMIND), University of California – Irvine, Irvine, USA,Corresponding author at: Department of Neuroscience, Imaging, and Clinical Sciences, “G. d'Annunzio”, University of Chieti-Pescara, Chieti, Italy
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19
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McAlpine LS, Lifland B, Check JR, Angarita GA, Ngo TT, Pleasure SJ, Wilson MR, Spudich SS, Farhadian SF, Bartley CM. RETRACTED: Remission of Subacute Psychosis in a COVID-19 Patient With an Antineuronal Autoantibody After Treatment With Intravenous Immunoglobulin. Biol Psychiatry 2021; 90:e23-e26. [PMID: 34001372 PMCID: PMC8041149 DOI: 10.1016/j.biopsych.2021.03.033] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 11/26/2022]
Abstract
Retraction notice to: “Remission of Subacute Psychosis in a COVID-19 Patient With an Antineuronal Autoantibody After Treatment With Intravenous Immunoglobulin” by Lindsay S. McAlpine, Brooke Lifland, Joseph R. Check, Gustavo A. Angarita, Thomas T. Ngo, Samuel J. Pleasure, Michael R. Wilson, Serena S. Spudich, Shelli F. Farhadian, and Christopher M. Bartley (Biol Psychiatry 2021; 90:e23-e26); https://doi.org/10.1016/j.biopsych.2021.03.033. This article has been retracted at the request of corresponding author Christopher Bartley, with agreement from all authors and with approval from Biological Psychiatry Editor John H. Krystal, M.D. See Elsevier Policy on Article Withdrawal (http://www.elsevier.com/locate/withdrawalpolicy). After this article was published, the authors determined that two cerebrospinal fluid (CSF) samples were inadvertently confused, resulting in publication of the wrong COVID-19 patient’s immunostaining data. The authors determined that the two CSF samples came from COVID-19 patients with sequential case identifiers (i.e., one identifier ended in a “5” and the other in a “6”). To determine whether the published immunostaining results were produced by CSF from another COVID-19 patient, the authors reperformed the mouse brain immunostaining experiments using additional aliquots of stored CSF from the two research participants in question, as well as with the remaining CSF that had been used in the publication. After repeating the immunostaining with these CSF samples, two blinded raters were able to state unequivocally that the CSF samples from the two COVID-19 patients had been confused. Therefore, while the clinical features of the case report are accurate and unaffected, the research data belong to another COVID-19 research participant, not the one described in the published case report. The authors voluntarily informed the Journal of this honest error upon its discovery. All authors agree to retract this paper and sincerely apologize for having allowed the incorrect images to be published with this case report. To avoid misinterpretation of the research findings, both the editors and authors concur that the only proper course of action was to retract this version of the paper. However, this COVID-19 psychosis case remains of clinical interest because of the patient’s clear response to immunotherapy. Therefore, the authors are revising the paper, which the Journal will consider further for publication.
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Affiliation(s)
- Lindsay S McAlpine
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
| | - Brooke Lifland
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Joseph R Check
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Gustavo A Angarita
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
| | - Thomas T Ngo
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California
| | - Samuel J Pleasure
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California; Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Michael R Wilson
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California; Department of Neurology, University of California, San Francisco, San Francisco, California
| | - Serena S Spudich
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
| | - Shelli F Farhadian
- Section of Infectious Diseases, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut
| | - Christopher M Bartley
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, California; Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, California; Hanna H. Gray Fellowship Program, Howard Hughes Medical Institute, Chevy Chase, Maryland
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20
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Abstract
PURPOSE OF REVIEW The coronavirus disease 19 (COVID-19) pandemic is having a critical impact on healthcare systems across the world, as well as on mental health in the general population; however, evidence regarding the impact of the COVID-19 pandemic on people living with schizophrenia and on the onset of psychotic symptoms is currently emerging. RECENT FINDINGS People living with schizophrenia are at an increased risk of COVID-19 and present worse COVID-19-related outcomes, including mortality. They show low levels of information and of concern regarding the possibility of contagion and infection but presented substantially stable levels of psychotic symptoms and even increased subjective well being during the pandemic. SARS-CoV-2, as well as the prolonged social isolation and the spread of misinformation, appear to be responsible in some cases for the onset of psychotic symptoms. SUMMARY Clinicians should inform and educate their patients on the risks related to SARS-CoV-2 infection and COVID-19 and on the precautions that they should adopt to avoid contagion. Particular attention should be devoted to maintaining the continuity of care, especially in frail patients. Telemedicine might represent a valid support, but face-to-face visits in some cases remain essential. The hypothesis of a direct role of viral infection on the onset of psychotic disorders is currently debated, as viral involvement of central nervous system appears to be rather infrequent in COVID-19.
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21
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Esposito CM, D'Agostino A, Dell Osso B, Fiorentini A, Prunas C, Callari A, Oldani L, Fontana E, Gargano G, Viscardi B, Giordano B, D'Angelo S, Wiedenmann F, Macellaro M, Giorgetti F, Turtulici N, Gambini O, Brambilla P. Impact of the first Covid-19 pandemic wave on first episode psychosis in Milan, italy. Psychiatry Res 2021; 298:113802. [PMID: 33592401 PMCID: PMC7874958 DOI: 10.1016/j.psychres.2021.113802] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 02/08/2021] [Indexed: 01/22/2023]
Abstract
The ongoing Corona Virus Disease 2019 (COVID-19) pandemic appears to increase risk for mental illness, either directly due to inflammation caused by the virus or indirectly due to related psychosocial stress, resulting in the development of both anxious-depressive and psychotic symptoms. The purpose of the present study was to assess the frequency and characteristics of all patients with First Episodes Psychosis (FEP) without COVID-19 infection hospitalized in the first four months since lockdown in Milan. We recruited sixty-two patients hospitalized between March 8 to July 8, 2020 versus those first hospitalized in the same period in 2019. The two subgroups were compared for sociodemographic variables and clinical characteristics of the episodes. Patients with FEP in 2020 were significantly older than patients with FEP in 2021, and presented with significantly less substances abuse. Interestingly, patients presenting with FEP in 2020 were significantly older than patients with FEP in 2019. These data are compatible with the greater vulnerability to stressful factors during the pandemic, as well as with the greater concern regarding a possible COVID-19 infection producing brain damage causing the FEP.
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Affiliation(s)
- C M Esposito
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A D'Agostino
- Department of Mental Health, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
| | - B Dell Osso
- Department of Scienze Biomediche e Cliniche 'Luigi Sacco', Università degli Studi di Milano, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Department of Psychiatry and Behavioural Sciences, Bipolar Disorders Clinic, Stanford Medical School, Stanford University, CA, USA
| | - A Fiorentini
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - C Prunas
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Callari
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - L Oldani
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - E Fontana
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - G Gargano
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - B Viscardi
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - B Giordano
- Department of Scienze Biomediche e Cliniche 'Luigi Sacco', Università degli Studi di Milano, Milan, Italy
| | - S D'Angelo
- Department of Scienze Biomediche e Cliniche 'Luigi Sacco', Università degli Studi di Milano, Milan, Italy
| | - F Wiedenmann
- Department of Scienze Biomediche e Cliniche 'Luigi Sacco', Università degli Studi di Milano, Milan, Italy
| | - M Macellaro
- Department of Scienze Biomediche e Cliniche 'Luigi Sacco', Università degli Studi di Milano, Milan, Italy
| | - F Giorgetti
- Department of Scienze Biomediche e Cliniche 'Luigi Sacco', Università degli Studi di Milano, Milan, Italy
| | - Ne Turtulici
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - O Gambini
- Department of Mental Health, San Paolo Hospital, ASST Santi Paolo e Carlo, Milan, Italy
- CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan Medical School, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - P Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
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22
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Smith CM, Gilbert EB, Riordan PA, Helmke N, von Isenburg M, Kincaid BR, Shirey KG. COVID-19-associated psychosis: A systematic review of case reports. Gen Hosp Psychiatry 2021; 73:84-100. [PMID: 34717240 PMCID: PMC8546431 DOI: 10.1016/j.genhosppsych.2021.10.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/19/2021] [Accepted: 10/20/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVES To describe the comorbidities, presentations, and outcomes of adults with incident psychosis and a history of COVID-19. METHODS We completed a descriptive systematic review of case reports according to PRISMA guidelines, including cases of adult patients with incident psychosis and antecedent or concurrent COVID-19. We extracted patient demographics, comorbidities, clinical course, and outcomes, and assessed cases for quality using a standardized tool. RESULTS Of 2396 articles, we included 40 reports from 17 countries, comprising 48 patients. The mean age of patients was 43.9 years and 29 (60%) were males. A total of 7 (15%) had a documented psychiatric history, 6 (13%) had a substance use history and 11 (23%) had a comorbid medical condition. Delusions were the most common (44 [92%]) psychiatric sign and psychosis lasted between 2 and 90 days. A total of 33 (69%) patients required hospitalization to a medical service and 16 (33%) required inpatient psychiatric admission. The majority (26 [54%]) of cases did not assess for delirium and 15 (31%) cases were judged to be of high risk of bias. CONCLUSIONS Despite the growing awareness of COVID-19's association with incident psychosis at a population level, cases of COVID-19-associated psychosis often lacked clinically relevant details and delirium was frequently not excluded. PROSPERO registration number: CRD42021256746.
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Affiliation(s)
- Colin M Smith
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Elizabeth B Gilbert
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Paul A Riordan
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Psychiatry, Durham Veteran Affairs Medical Center, Durham, NC, USA
| | - Nicole Helmke
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Megan von Isenburg
- Duke University Medical Center Library, Duke University Medical Center, Durham, NC, USA
| | - Brian R Kincaid
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kristen G Shirey
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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