How coronavirus patients could experience delirium and PTSD after recovering

A report by the UCL Institute of Mental Health with King’s College London collaborators was published yesterday in The Lancet Psychiatry. It examined the results of studies into patients hospitalised by Covid-19 as well as SARS and MERS – two other coronaviruses.

The report suggests that delirium could be a symptom in many severe coronavirus cases – as many as one in four, Eurakalert said. The NHS defines delirium as “sudden confusion”.

The report states in its interpretation of the findings: “If infection with SARS-CoV-2 follows a similar course to that with SARS-CoV or MERS-CoV, most patients should recover without experiencing mental illness.”

But it also warned that “SARS-CoV-2 might cause delirium in a significant proportion of patients in the acute stage.

“Clinicians should be aware of the possibility of depression, anxiety, fatigue, post-traumatic stress disorder, and rare neuropsychiatric syndromes in the longer term.”

It also claimed that mental illness in patients hospitalised with Covid-19 could be “compounded by the effects of social isolation.”

Eurekalert claims that delirium is a known problem in hospital patients, and that it can prolong the amount of time that a person in in hospital or even increase risk of death.

However, most people who are infected by Covid-19 will not experience any psychiatric disorder as a result of the virus, the paper concluded.

And it adds that beyond short-term delirium, there is “little to suggest that common neuropsychiatric complications” are a feature of Covid-19 infection.

The paper’s Co-lead author Dr Jonathan Rogers from UCL Psychiatry as well as the South London and Maudsley NHS Foundation Trust said: “Most people with Covid-19 will not develop any mental health problems, even among those with severe cases requiring hospitalisation”.

But still, the report stated that the mental health impact caused by Covid-19 could be “considerable” due to the large number of people infected globally.

And it warned that health professionals must still be aware that depression, fatigue, post-traumatic stress disorder (PTSD) and other mental health issues may possibly present themselves in the aftermath of a Covid-19 infection.

The paper states in its interpretation of the findings: “If infection with SARS-CoV-2 follows a similar course to that with SARS-CoV or MERS-CoV, most patients should recover without experiencing mental illness.

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“SARS-CoV-2 might cause delirium in a significant proportion of patients in the acute stage. Clinicians should be aware of the possibility of depression, anxiety, fatigue, post-traumatic stress disorder, and rare neuropsychiatric syndromes in the longer term.”

But as well as looking at the indirect consequences of the virus on mental health, such as anxiety associated with having the virus or other low moods caused by social distancing, the report also looked at how the virus might directly affect the brain.

It states there is some evidence that Covid-19 could replicate inside the neurons of the brain – something that SARS possibly did not do.

“There is preliminary in-vitro evidence that – possible unlike SARS coronavirus (SARS-CoV) – SARS-CoV-2 can replicate in neuronal cells, but the translation of this finding to in-vivo settings remains unclear.

“Even if severe neuropsychiatric consequences are proportionately rate, a considerable number of individuals worldwide would be affected.”

Meanwhile, mental health charities have published advice for people who are struggling with life in lockdown.

Mind has issued “practical advice for staying at home” on its website, which includes tips on working from home, eating well and staying hydrated, and more.

It also provides advice on those who may feel anxious because of advice surrounding hand washing and hygiene.

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