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Preexisting mild cognitive impairment as a risk factor for COVID-19 infection: A scoping review and case reports

Published online by Cambridge University Press:  01 September 2022

P. Catapano*
Affiliation:
Università degli studi della Campania “Luigi Vanvitelli”, Dipartimento Di Psichiatria, Napoli, Italy
M. Messina
Affiliation:
Università degli studi della Campania “Luigi Vanvitelli”, Dipartimento Di Psichiatria, Napoli, Italy
A. Russo
Affiliation:
Università degli studi della Campania “Luigi Vanvitelli”, Dipartimento Di Salute Mentale E Fisica E Medicina Preventiva, Napoli, Italy
C. Tucci
Affiliation:
Università degli studi della Campania “Luigi Vanvitelli”, Dipartimento Di Psichiatria, Napoli, Italy
M. Luciano
Affiliation:
University of Campania “Luigi Vanvitelli”, Department Of Psychiatry, Naples, Italy
V. De Santis
Affiliation:
Università degli studi della Campania “Luigi Vanvitelli”, Dipartimento Di Psichiatria, Napoli, Italy
F. Perris
Affiliation:
University of Campania “Luigi Vanvitelli”, Department Of Psychiatry, Naples, Italy
F. Catapano
Affiliation:
University of Campania “Luigi Vanvitelli”, Department Of Psychiatry, Naples, Italy
N. Coppola
Affiliation:
Università degli studi della Campania “Luigi Vanvitelli”, Dipartimento Di Salute Mentale E Fisica E Medicina Preventiva, Napoli, Italy
M. Fabrazzo
Affiliation:
University of Campania “Luigi Vanvitelli”, Department Of Psychiatry, Naples, Italy
*
*Corresponding author.

Abstract

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Introduction

SARS-Co-V2 neuroinvasive ability might be the basis for the onset of delirium and neuropsychiatric outcomes.

Objectives

We hypothesized that some infected patients with preexisting cognitive dysfunction may present delirium as unique manifestation of COVID-19 infection or as a prodrome of a new episode consistent with the psychiatric history.

Methods

We conducted a PubMed literature search to verify whether cognitive impairment might predispose to COVID-19. We included three patients with mild cognitive impairment and delirium at admission for SARS-Co-V2 suspected infection. Delirium was diagnosed according to DSM-5 criteria‚ Cognitive Assessment Method and Coma Glasgow Scale.

Results

Literature analysis evidenced patients presenting delirium or delirium-like symptoms as clinical manifestation of COVID-19, plus a cognitive impairment‚ from mild to severe‚ which preexisted or was evidenced during the acute phase or after the infection. Most studies described delirium in patients with a past neurological/psychiatric history. Contrasting data emerged on the potential link between COVID-19 and delirium in patients with cognitive impairment and without a past neuropsychiatric history. Our patients had no history of other medical complications. Our first patient had no psychiatric history‚ the second reported only a depressive episode‚ and the third had story of bipolar disorder. Delirium resolved completely after 2 days in the first patient. The other patients required 4 and 14 days to resolve: delirium appeared as the prodrome of a new psychiatric episode in line with their past history.

Conclusions

Clinicians should acknowledge the possibility that COVID-19 infection may appear as delirium and acute psychiatric sequelae as unique manifestation.

Disclosure

No significant relationships.

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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