Evaluation of Neuropsychiatric Complications in Hospitalized COVID-19 Patients.

BACKGROUND: Previous research has shown that COVID-19 patients are at risk of developing mental disorders. Limited number of studies about psychiatric and neuropsychiatric presentations in hospitalized COVID-19 patients is currently available. SUBJECTS AND METHODS: Subjects were 172 patients diagnosed with COVID-19 and requiring inpatient care, hospitalized at reprofiled clinics of the university hospital. The study aimed to quantify psychiatric symptoms, and determine correlations with agitation, BMI, mortality, and other variables (age, sex, oxygen therapy, intubation, etc.). RESULTS: Mental disorders due to known physiological conditions were of highest prevalence (n=105, 62.9%), followed by anxiety, dissociative, stress-related, somatoform and other nonpsychotic mental disorders (n=34, 20.4%), and dementia (n=21, 12.6%) in COVID-19 patients. Depressive disorders (n=13, 7.9%), alcohol related disorders associated with withdrawal symptoms (n=10, 6%), and schizophrenia, schizotypal, delusional, and other non-mood psychotic disorders (n=4, 2.4%) were less common. Patients diagnosed with mental disorders due to known physiological conditions were significantly older compared to patients with other diagnoses. The depression was observed more commonly in patients treated with high-flow nasal oxygen (HFNO), and patients disconnected from invasive mechanical ventilation (IMV). Mixed anxiety-depressive symptoms were observed in 23.8% of the patients (n=41), and they were more prevalent in younger patients compared to patients without anxiety-depressive symptoms. Agitated patients were significantly older than non-agitated patients. No connection was observed between the occurrence of agitation and treatment with HFNO, nor in case of patients disconnected from IMV; however, the relationship between agitation and death proved to be statistically significant (OR = 5.9, 95% CI 2.33-15.29). CONCLUSION: Analysis of psychiatric and neuropsychiatric presentations in COVID-19 patients and their correlation with multiple variables provides a better understanding of the effect of infection on mental health, and brings forth a necessity of transdisciplinary approach in handling COVID-19 patients.

Outbreak of Alimentary Tick-Borne Encephalitis in Eastern Slovakia: An Analysis of Affected Patients and Long-Term Outcomes.

OBJECTIVE: Tick-borne encephalitis (TBE) is an endemic zoonotic viral disease in many European countries and in the central and eastern parts of Asia. Slovakia reports the highest occurrence of alimentary tick-borne encephalitis in Europe, after the consumption of unpasteurized milk and cheese from domestic ruminants. In May 2016, an outbreak of tick-borne encephalitis that emerged after the consumption of sheep cheese occurred in eastern Slovakia. In total, 44 people were ill and 36 were hospitalized. METHODS: Data from the 36 hospitalized patients at the Department of Infectology and Travel Medicine in Kosice with TBE were retrospectively analysed from the medical documentation. The patients were contacted 3 years after discharge. RESULTS: Twenty of the hospitalized patients had meningoencephalitis and 16 had meningitis. The main symptoms that occurred in all patients were fever and headache. Nuchal rigidity was seen in 50% of the patients. Three patients developed late systemic complications and another six patients had psychiatric complications. None of the patients died. Three years after the disease onset, 52% of contacted patients reported persistent discomfort. CONCLUSIONS: TBE is an infection with a wide range of clinical courses. Our findings suggest that alimentary-acquired TBE lead to severe disease and persistent discomfort.

Seroprevalence of hepatitis E among hospitalized patients in Slovakia: first report.

OBJECTIVE: Hepatitis E infection is one of the most frequent acute hepatitis in the world. Currently five human genotypes with different geographical distributions and distinct epidemiologic patterns are identified. In Slovakia, only rare cases of hepatitis E have been reported in recent years. Therefore, the aim of the study was to evaluate the prevalence of anti-HEV total antibodies and the main risk factors for HEV in the general population in Eastern Slovakia. METHODS: Detection of anti-HEV total antibodies samples was done by a commercial enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: Of 175 hospitalized patients included in the study, 76 (43.5%) showed positivity for anti-HEV total antibodies. No statistically significant differences were found in anti-HEV positivity between men and women or in the groups of different living areas (town/village - urban/rural). CONCLUSION: Prevalence of anti-HEV total antibodies of hospitalised patients was high. The risk factor significantly associated with antibody positivity was eating raw meat. Other factors, such as sex, age, living area and contact with animals were not associated with antibody positivity.

[Tick-borne encephalitis in a pregnant patient].

There is a lack of information in the literature about the course and risk of vertical transmission of tick-borne encephalitis (TBE) during pregnancy. Presented is a case report of a female patient in the 37th week of pregnancy infected by foodborne transmission. She developed meningitis with no neurological damage. Three weeks after the first symptoms, she gave birth to a healthy child who, at the age of 30 months, had a negative result of anti-TBE antibodies in both IgM and IgG classes. In the child, no signs of neurological injury or impaired psychomotor development were observed throughout the follow-up period.