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Management challenges in patients with comorbid COVID-19 associated delirium and serious mental illness - A case
Saba Syed1,2, Michael Couse3, Rashi Ojha1
1David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Insights
This study highlights the challenges of managing COVID-19 in patients with serious mental illness. Collaboration between medical and psychiatric teams is crucial for effective diagnosis and treatment.
Area of Science:
- Medicine
- Psychiatry
- Infectious Diseases
Background:
- The novel Coronavirus Disease 19 (COVID-19) pandemic presents unique clinical challenges.
- Understanding COVID-19's impact on individuals with serious mental illness (SMI) is critical.
Observation:
- This study reviewed four patients with SMI on psychotropic polypharmacy admitted with COVID-19.
- These patients experienced COVID-19 delirium and associated medical complications.
Findings:
- Effective management requires collaboration between primary medical teams and psychiatrists.
- Key aspects include diagnostic clarification and psychotropic medication adjustment.
Implications:
- Interdisciplinary collaboration is essential for managing COVID-19 in SMI patients.
- Strategies include reducing polypharmacy, preventing psychiatric decompensation, and managing agitation safely.
Background:
There is still a lot unknown about the novel Coronavirus Disease 19 (COVID-19) and its effects in humans. This pandemic has posed several challenging clinical situations to healthcare providers.
Objective:
We hope to highlight the distinctive challenges that COVID-19 presents in patients with serious mental illness and what steps primary medical teams can take to co-manage these patients with the psychiatry consultants.
Methods:
We present a retrospective chart review of four patients who were on psychotropic polypharmacy and admitted to our hospital from the same long-term psychiatric facility with COVID-19 delirium and other associated medical complications.
Results:
We illustrate how the primary medical teams and psychiatrists collaborated in clinical diagnosis, treatment, and management.
Conclusions:
Patients with serious mental illness and COVID-19 infection require active collaboration between primary medical teams and psychiatrists for diagnostic clarification, reduction of psychotropic polypharmacy to avoid adverse effects and drug-drug interactions, prevention of psychiatric decompensation, and active management of agitation while balancing staff and patient safety concerns.
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