Covid-19 Induced Catatonia: A Review Of This Rare Phenomenon.

BACKGROUND: Catatonia is a psychomotor syndrome characterized by numerous clinical features, a few being stupors which is the most common sign, posturing, forced grasping, echopraxia, etc. There have been cases documented in the literature of Catatonia occurring with COVID-19. This article will focus on the complete and brief overview of catatonia observed in patients with COVID-19 infection. METHODS: We outline the evidence of the pathophysiology of COVID-19 in the CNS system, the effect of the virus in inducing catatonia, and its outcome. The literature used in the article is mostly case reports from different parts of the world thus; we have generalized our review taking into consideration multiple factors. RESULTS: In patients with COVID-19, neuropsychiatric manifestations are very commonly appreciated. Catatonia has been documented in many patients along with respiratory symptoms such as fever, shortness of breath, and cough. There are multiple etiologies associated with this presentation which have been discussed in detail in this article. In many patients, there was no history of any psychiatric illness. The timing of presenting with catatonic features was also different for different individuals. CONCLUSIONS: COVID-19 has been believed to contribute to the presentation of catatonia. There is no specific timeline between the onset of symptoms and the presence of COVID-19 infection. However, coronavirus can be responsible in a few ways for inducing catatonia in patients with or without any previous psychiatric illness. Therefore, COVID-19 should be considered as one of the major factors in this complex psychiatric disease, catatonia.

A Spectrum of Pulmonary Complications Occurring in End-Stage Renal Disease Patients on Maintenance Hemodialysis.

Objective To investigate the trends of end-stage renal disease (ESRD) in patients undergoing maintenance hemodialysis (MHD) and find the correlation with effects on the pulmonary system in such patients. Methodology A multicentric prospective study was conducted in the city of Solapur, India. Data were collected from 250 patients through interpersonal interrogation using a questionnaire to capture basic demographic details, the history of ESRD, and relevant respiratory symptoms like breathlessness, cough, fever, etc. related to their disease. Symptoms that are likely associated with the pulmonary system were analyzed and referred to the pulmonology department. Appropriate diagnoses were made using relevant diagnostic tools like X-rays and sputum studies. The association between various disease attributes and pulmonary diagnoses was analyzed using the chi-square (χ2) test, with a p-value of value less than or equal to 0.05 considered statistically significant. Various socio-demographic variables, existing comorbidities, occupation-related risk factors, smoking history, past or current history of any respiratory conditions, the association between the causes of ESRD, time since the first dialysis and sociodemographic factors, and frequency of pulmonary complications were the other covariates in the study. Results Our study reports that 31.6% of our patients had significant impairment in their functioning due to respiratory complaints. The prevalence of respiratory complications was 27.2%. Major contributors were pleural effusion (33.8), pneumonia (25), pulmonary edema (20.58), pleuritis (11.76), collapse (8.8), tuberculosis (5.8), fibrosis (4.4), pericardial effusion (4.4), calcification (2.9), and hydrothorax (1.47). We report one case of Urinothorax as a rare cause of hydrothorax in such patients. Overall, our analysis found a significant association between non-reporting of respiratory complaints and acute admissions to the intensive care unit (ICU) with a respiratory cause at p-value 0.0076 with a greater predilection toward the rural populations. Conclusion Our study results highlight the prevalence of pulmonary complications in ESRD patients. The occurrence of pulmonary complications, irrespective of the presence of symptoms and a greater association between non-reporting of respiratory symptoms and acute admissions to the ICU, is a hallmark to consider the importance of history and clinical vigilance during patient visits.