Mental disorders, psychopharmacological treatments, and mortality in 2150 COVID-19 Spanish inpatients.

OBJECTIVE: To determine how mental disorders and psychopharmacological treatments before and during COVID-19 hospital admissions are related to mortality. METHODS: Subjects included in the study were all adult patients with a diagnosis of COVID-19, confirmed clinically and by PCR, who were admitted to a tertiary university hospital in Badalona (Spain) between March 1 and November 17, 2020. Data were extracted anonymously from computerized clinical records. RESULTS: 2,150 subjects were included, 57% males, mean age 61 years. History of mental disorders was registered in 957 (45%). Throughout admission, de novo diagnosis of mood or anxiety, stress, or adjustment disorder was made in 12% of patients without previous history. Delirium was diagnosed in 10% of cases. 1011 patients (47%) received a psychotropic prescription during admission (36% benzodiazepines, 22% antidepressants, and 21% antipsychotics). Mortality rate was 17%. Delirium during admission and history of mood disorder were independently associated with higher mortality risk (hazard ratios, 1.39 and 1.52 respectively), while previous year's treatments with anxiolytics/hypnotics and antidepressants were independently associated with lower mortality risk (hazard ratios, 0.47 and 0.43, respectively). CONCLUSION: Mental symptoms are very common in patients hospitalized for COVID-19 infection. Detecting, diagnosing, and treating them is key to determining the prognosis of the disease and functional recovery.

[Catatonia: Back to the future of the neuropsychiatric syndrome]. / Catatonia: regreso al futuro del síndrome neuropsiquiátrico.

Catatonia is an undertreated and underdiagnosed neuropsychiatric syndrome whose prognosis is benign if treated early, thus avoiding possible complications and compromising the health of patients. The latest epidemiological studies indicate a prevalence of catatonia of 9.2%, being frequent in medical pathologies (especially neurological ones), as well as in psychiatric pathologies. The use of validated scales is recommended for its diagnosis, to be able to measure the severity and response to treatment. Once catatonia has been identified, it is necessary to perform a protocolized diagnostic study of the underlying aetiology («Catatonia Workup¼). Treatment of choice is benzodiazepines and electroconvulsive therapy. In recent years, new therapeutic alternatives such as non-invasive transcranial magnetic stimulation have emerged. In this review we propose several initiatives to promote the dissemination and knowledge of catatonia in the clinical setting.

Catatonia and Cognitive Impairments: A Systematic Review.

Background: Catatonia is an underdiagnosed and undertreated neuropsychiatric syndrome characterized by catalepsy, negativism, mutism, muscular rigidity, and mannerism, often accompanied by autonomic instability and fever. Although there is growing interest in studying cognitive impairments before and after catatonia, little is known about the cognitive features of the syndrome. Methods: This systematic review was registered at PROSPERO (CRD42022299091). Using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach, we searched PubMed, ScienceDirect, and PsycArticles using a combination of the terms "Catatonia" and "Cognitive impairment" and "Executive function" and "Frontal lobe" and "Parietal lobe." Studies included original research articles enrolling patients with catatonic syndrome according to specified criteria. Fourteen studies were deemed relevant for inclusion. The abstraction form included age, assessment during acute episode, associated diagnosis, assessment procedure, and cognitive domains. Outcome measures were extracted. Results: Executive functions and visuospatial abilities proved to be the most investigated domains. A great heterogeneity has been observed in the assessment tools used among the 14 evaluated studies. Findings showed that catatonic patients had worse performance than healthy and non-catatonic psychiatric patients in frontal and parietal cortical functions. Conclusion: Because of the small number of studies in such heterogeneous areas and significant methodological limitations, the results should be regarded with caution. Future research assessing cognitive impairments on catatonic patients is needed. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=299091], identifier [CRD42022299091].

Association of serum interleukin-6 and C-reactive protein with depressive and adjustment disorders in COVID-19 inpatients.

BACKGROUND: Immune mechanisms are part of the pathophysiology of mental disorders, although their role remains controversial. In depressive disorders a chronic low-grade inflammatory process is observed, with higher interleukin-6 (IL-6) values. Furthermore, in SARS-CoV2 infection, which is closely related to depressive disorders, there is a proinflammatory cascade of cytokines that causes systemic inflammation. METHODS: The present study evaluates the relationship between IL-6 and C-reactive protein (CRP) serum levels and the presence of depressive and adjustment disorders in a sample of 1851 patients admitted to hospital for SARS-CoV2 infection from March to November 2020. Concentrations of IL-6 and CRP were determined within the first 72 â€‹h at admission and compared among groups of patients according to previous history and current presence of depression or adjustment disorders. RESULTS: IL-6 serum levels were significantly higher in the group of patients with depression and adjustment disorders compared to patients without such disorders (114.25 â€‹pg/mL (SD, 225.44) vs. 86.41 (SD, 202.97)), even after adjusting for several confounders. Similar results were obtained for CRP (103.94 â€‹mg/L (SD, 91.16) vs. 90.14 (SD, 85.73)). The absolute levels of IL-6 and CRP were higher than those of previous depression studies, and differences were only found for the subgroup of De Novo depressive or adjustment disorders. CONCLUSIONS: Serum concentrations of IL-6 and CRP are higher in COVID-19 patients with De Novo but not persistent depressive or adjustment disorders. Clinical features such as fatigue, asthenia, anhedonia, or anxiety can be the basis for this finding.

[INTEGRATING RISK PREVENTION IN THE PROCUREMENT OF DISINFECTION PRODUCTS: THE EVOLUTION OF HOSPITAL DISINFECTION PRODUCT COMPOSITION IN THE CATALONIAN HEALTH INSITUTE, 2008-2017]. / Integración de la prevención de riesgos en el proceso de compra de desinfectantes hospitalarios del Instituto Catalán de la Salud entre los años 2008 y 2017.

In hospitals, the disinfection of surfaces and medical instruments is essential for preventing the spread of infections associated with hospital admissions. For this reason, between 2008 and now, the Catalonian Institute of Health (ICS, by its Spanish acronym) has been replacing several potentially harmful disinfection products, , such as aldehydes and carcinogens, with less hazardous compounds such as oxidizing products and alcohols, that are safe and also efficient for the disinfection of work surfaces and medical instruments. This paper summarizes our experience, as an example of the integration of risk prevention in healthcare institutions.

La desinfección de superficies y de material es una tarea imprescindible en los hospitales para evitar la propagación de infecciones asociadas a la estancia hospitalaria de los pacientes. Por eso, en el Instituto Catalán de la Salud (ICS) en el periodo 2008-2017 se han ido sustituyendo los diversos productos desinfectantes que son nocivos para la salud de los trabajadores, como aldehídos y cancerígenos, por otros menos peligrosos, como los productos oxidantes y alcoholes, que dan también un resultado eficiente y seguro en la desinfección del material y de las superficies. Este trabajo recoge esta experiencia como forma de integración de la prevención de riesgos en la empresa.