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    COVID-19 MESHD and mortality risk in patients with psychiatric disorders MESHD

    Authors: George Kirov; Emily Baker

    doi:10.1101/2021.04.08.21255046 Date: 2021-04-13 Source: medRxiv

    COVID-19 MESHD has already caused the deaths of over 2.5 million people worldwide. Patients with certain medical conditions and severe psychiatric disorders MESHD are at increased risk of dying from it. However, such people have a reduced life expectancy anyway, raising the question whether COVID-19 MESHD incurs a specific risk for such patients for dying, over and above the risk of dying from other causes. We analysed the UK Biobank data of half a million middle-aged participants from the UK. From the start of 2020 up to 24th January 2021, 894 participants had died from COVID-19 MESHD and another 4,562 had died from other causes. We demonstrate that the risk of dying from COVID-19 MESHD among patients with mental health problems, especially those with dementia MESHD, schizophrenia MESHD, or bipolar disorder MESHD, is increased compared to the risk of dying from other causes. This increase among patients with severe psychiatric disorders MESHD cannot be explained solely by the higher rate of diabetes or cardiovascular disorders MESHD.

    Which traits predict elevated distress during the Covid-19 pandemic MESHD? Results from a large, longitudinal MESHD cohort study with psychiatric MESHD patients and healthy controls

    Authors: Katharina Brosch; Tina Meller; Julia-Katharina Pfarr; Frederike Stein; Simon Schmitt; Kai G. Ringwald; Lena Waltemate; Hannah Lemke; Katharina Thiel; Elisabeth Schrammen; Carina Huelsmann; Susanne Meinert; Katharina Dohm; Elisabeth J. Leehr; Nils Opel; Axel Krug; Udo Dannlowski; Igor Nenadic; Tilo Kircher

    doi:10.1101/2021.04.01.21254625 Date: 2021-04-05 Source: medRxiv

    Background: The Covid-19 pandemic MESHD resulted in repeated, prolonged restrictions in daily life. Social distancing policies as well as health anxiety MESHD are thought to lead to mental health impairment. However, there is lack of longitudinal data identifying at-risk populations particularly vulnerable for elevated Covid-19 MESHD-related distress. Methods: We collected data of N=1268 participants (n=622 healthy controls ( HC MESHD), and n=646 patients with major depression MESHD, bipolar disorder MESHD, schizophrenia or schizoaffective disorder MESHD) at baseline (2014-2018) and during the first lockdown in Germany (April-May 2020). We obtained information on Covid-19 MESHD restrictions (number and subjective impact of Covid-19 MESHD events), and Covid-19 MESHD-related distress (i.e., subjective fear and isolation). Using multiple linear regression models including trait variables and individual Covid-19 MESHD impact, we sought to predict Covid-19 MESHD-related distress. Results: HC MESHD and patients reported similar numbers of Covid-19 MESHD-related events, and similar subjective impact rating. They did not differ in Covid-19 MESHD-related subjective fear. Patients reported significantly higher subjective isolation. 30.5% of patients reported worsened self-rated symptoms since the pandemic. Subjective fear in all participants was predicted by four variables: trait anxiety MESHD (STAI-T), conscientiousness (NEO-FFI), Covid-19 MESHD impact, and sex. Subjective isolation in HC MESHD was predicted by social support (FSozu), Covid-19 MESHD impact, age, and sex; in patients, it was predicted by social support and Covid-19 MESHD impact. Conclusion: Our data shed light on differential effects of the pandemic in psychiatric MESHD patients and HC MESHD. They identify relevant, easy-to-obtain variables for risk profiles related to interindividual differences in Covid-19 MESHD-related distress for direct translation into clinical practice. Keywords: Covid-19 MESHD, mental health, stress, Big Five, social support

    Subjective mental health and need for care among psychiatric outpatients during the COVID-19 MESHD COVID-19 MESHD pandemic: results from an outreach initiative in Sweden

    Authors: Oskar Flygare; Volen Z Ivanov; Roland Sall; Henrik Malaise; Christian Ruck; Nitya Jayaram-Lindstrom; Lina Martinsson

    doi:10.1101/2020.11.10.20229039 Date: 2020-11-13 Source: medRxiv

    Importance: The ongoing COVID-19 pandemic MESHD COVID-19 pandemic MESHD restricts access to care for psychiatric MESHD patients. The physical and mental well-being of patients with severe mental illness MESHD in the current circumstances is unknown. Objective: To evaluate physical and mental well-being, subjective mental health, and need for updated psychiatric MESHD management plans in a sample of patients with severe mental illness MESHD during the early stages of the COVID-19 pandemic MESHD. Design: Cross-sectional study of structured telephone assessments conducted between April 23 and June 30, 2020. Setting: Regional psychiatric MESHD outpatient care centre in Stockholm, Sweden. Participants: Patients who had not been in contact with their psychiatric MESHD clinic between April 9 and April 23, 2020. A total of 1071 patients were contacted by phone. Exposures: Occurrence of respiratory symptoms, changes in psychiatric symptoms MESHD, and the need for updated psychiatric MESHD management plans, as determined by the telephone assessors. Subjective mental health rated 0-100 by patients. Main Outcomes and Measures: Self-rated physical, respiratory and psychiatric MESHD symptoms according to a semi-structured interview. Subjective mental health rated on a scale from 0-100. Results: Patients (n = 1071) were on average 45 years old (SD = 16.9), of which 570 (53%) were female. Neurodevelopmental disorders MESHD, psychotic disorders MESHD, and bipolar disorder MESHD were the most common diagnostic categories. The majority of respondents reported no respiratory symptoms (86%), and few reported light (10%) or severe (4%) respiratory symptoms. Similarly, most patients reported no worsening in psychiatric symptoms MESHD (81%). For those who reported a worsening of psychiatric symptoms MESHD (19%), the psychiatric MESHD management plans that were already in place were deemed appropriate in most cases (16.5%), whereas 22 patients (2.5%) reported a worsening of psychiatric symptoms MESHD that warranted an earlier or immediate follow-up by their psychiatric MESHD clinic. Patients rated their subjective mental health on a 0-100 scale as 70.5 [95% CI 69 - 71.9] on average (n = 841). Response rates to the questions of the structured assessment varied from 79% - 82%. Conclusions and Relevance: The majority of patients reported no respiratory symptoms, no change in psychiatric symptoms MESHD and a rather high subjective well-being. Patients in psychiatric MESHD care with a mental health care plan experienced stability in the management of their psychiatric MESHD symptoms and general well-being, and only a minority were in need of acute support during the early pandemic phase in Stockholm, Sweden.

    Clozapine: An Updated Overview of Pharmacogenetic Biomarkers, Risks, and Safety—Particularities in the Context of COVID-19 MESHD

    Authors: Ana Miruna Dragoi; Ioana Radulescu; Anca Lucia Pop; Bogdana Adriana Năsui; Valentin Varlas; Simona Trifu

    id:10.20944/preprints202009.0724.v2 Date: 2020-11-09 Source: Preprints.org

    Background: Clozapine (CLZ) use is precarious due to its neurological, cardiovascular, and hematological side effects; however, it is the gold standard in therapy-resistant schizophrenia MESHD (TRS) in adults and is underused. Objective: to examine the most recent CLZ data on (a) side effects concerning (b) recent pharmacological mechanisms, (c) therapy benefits, and (d) the particularities of the COVID-19 MESHD COVID-19 MESHD pandemic. Data sources: a search was performed in two databases (PubMed and Web of Science) using the specific keywords "clozapine" and " schizophrenia MESHD," "side effects," " agranulocytosis MESHD," "TRS," or " bipolar affective disorder MESHD ( BAF MESHD)" for the last ten years. Study eligibility criteria: clinical trials on adults with acute symptoms of schizophrenia MESHD or related disorders. Results: We selected 37 studies, randomized controlled trials (RCTs), and clinical case series (CCS), centered on six main topics in the search area: (a) CLZ in schizophrenia MESHD, (b) CLZ in bipolar disorder MESHD, (c) side effects during the clozapine therapy, (d) CLZ in pregnancy, (e) CLZ in early-onset schizophrenia MESHD, and (f) CLZ therapy and COVID-19 MESHD infection. Limitations: We considered RCTs and CCS from two databases, limited to the search topics. Conclusions and implications of key findings: (a) Clozapine doses should be personalized for each patient based on pharmacogenetics testing when available; the genetic vulnerability postulates predictors of adverse reactions' severity; patients with a lower genetic risk could have less frequent hematological monitoring; (b) CLZ-associated risk of pulmonary embolism MESHD imposes prophylactic measures for venous thromboembolism MESHD; (c) convulsive MESHD episodes are not an indication for stopping treatment; the plasma concentration of clozapine is a better side effect predictor than the dosage; (d) COVID-19 MESHD infection may enhance clozapine toxicity MESHD, generating an increased risk of pneumonia MESHD. Therapy must be continued with proper monitoring of the white blood count, and the clozapine dose decreased by half until three days after the fever MESHD breaks; psychiatrists and healthcare providers must act together. Background: Clozapine (CLZ) use is precarious due to its neurological, cardiovascular, and hematological side effects; however, it is the gold standard in therapy-resistant schizophrenia MESHD (TRS) in adults and is underused. Objective: to examine the most recent CLZ data on (a) side effects concerning (b) recent pharmacological mechanisms, (c) therapy benefits, and (d) the particularities of the COVID-19 pandemic MESHD. Data sources: a search was performed in two databases (PubMed and Web of Science) using the specific keywords "clozapine" and " schizophrenia MESHD," "side effects," " agranulocytosis MESHD," "TRS," or " bipolar affective disorder MESHD ( BAF MESHD)" for the last ten years. Study eligibility criteria: clinical trials on adults with acute symptoms of schizophrenia MESHD or related disorders. Results: We selected 37 studies, randomized controlled trials (RCTs), and clinical case series (CCS), centered on six main topics in the search area: (a) CLZ in schizophrenia MESHD, (b) CLZ in bipolar disorder MESHD, (c) side effects during the clozapine therapy, (d) CLZ in pregnancy, (e) CLZ in early-onset schizophrenia MESHD, and (f) CLZ therapy and COVID-19 MESHD infection. Limitations: We considered RCTs and CCS from two databases, limited to the search topics. Conclusions and implications of key findings: (a) Clozapine doses should be personalized for each patient based on pharmacogenetics testing when available; the genetic vulnerability postulates predictors of adverse reactions' severity; patients with a lower genetic risk could have less frequent hematological monitoring; (b) CLZ-associated risk of pulmonary embolism MESHD imposes prophylactic measures for venous thromboembolism MESHD; (c) convulsive MESHD episodes are not an indication for stopping treatment; the plasma concentration of clozapine is a better side effect predictor than the dosage; (d) COVID-19 MESHD infection may enhance clozapine toxicity MESHD, generating an increased risk of pneumonia MESHD. Therapy must be continued with proper monitoring of the white blood count, and the clozapine dose decreased by half until three days after the fever MESHD breaks; psychiatrists and healthcare providers must act together.

    Psychiatric side effects induced by chloroquine and hydroxychloroquine: a systematic review of case reports and population studies

    Authors: Fernanda Talarico; Sucheta Chakravarty; Yang Liu; Angrew Greenshaw; Ives Passos; Bo Cao

    doi:10.1101/2020.10.05.20207423 Date: 2020-10-07 Source: medRxiv

    Chloroquine and hydroxychloroquine are commonly used drugs in the treatment of malaria MESHD as well as chronic diseases, such as rheumatoid arthritis MESHD, and systemic lupus erythematosus MESHD. Although various reports on possible psychiatric MESHD side effects of these drugs exist, the nature and extent of these effects remain poorly understood. Moreover, the relevance of these drugs in the treatment of early stages of COVID-19 MESHD necessitates a careful estimation of their side effects. Here, we provide a systematic review of the psychiatric MESHD side effects associated with chloroquine and hydroxychloroquine. We used PubMed, Scopus, and Web of Science platforms to identify relevant literature published between 1962 and 2020. Search terms included chloroquine, hydroxychloroquine, psychiatry, psychosis MESHD, depression MESHD, anxiety MESHD, bipolar disorder MESHD, delirium MESHD, and psychotic disorders MESHD. Only case reports and clinical trials were included. All studies included records of psychiatric MESHD side effects induced by either chloroquine or hydroxychloroquine or both. Both retrospective and prospective, randomized as well as non-randomized population studies were included. Overall, the psychiatric MESHD side effects are dose- and sex-independent. The most common psychiatric MESHD side effects reported are increased speech output/ excessive talking, increased psychomotor activity, irritable mood MESHD, auditory hallucinations MESHD, delusion of grandiosity, and suicide attempts, likely due to brain intoxicationbe of chloroquine or hydroxychloroquine. The symptoms can develop in a few hours to 11 weeks after drug intake and are normally reversed within a week after the drug withdrawal. We conclude that CQ and HCQ have the potential to induce psychiatric MESHD side effects. This study calls for further investigation of psychiatric symptoms MESHD induced by these drugs in the short and long term.

    Clozapine. Pharmacodynamic Mechanisms, Potential Pharmacogenetic Biomarkers, and Risks in Schizophrenia. Particularities in the Context of Covid-19 MESHD. An Updated Overview

    Authors: Ana Miruna Dragoi; Ioana Radulescu; Anca Lucia Pop; Bogdana Adriana Năsui; Valentin Varlas; Simona Trifu

    id:202009.0724/v1 Date: 2020-09-30 Source: Preprints.org

    Background: Clozapine use is precarious due to its side effects - neurological, cardiovascular, and hematological; however, it is the gold standard in the therapy of resistant schizophrenia MESHD (TRS) in adults and harshly underused. Objective: Our purpose is to systematically examine the most recent data regarding clozapine in order to update the knowledge in pharmacological mechanisms, therapy benefits versus side effects to optimize its use in the context of a narrow and scarce of resources pathology, with particularities in the COVID-19 pandemic MESHD COVID-19 pandemic MESHD. (2) Data sources: We performed an accurate search in the primary sources of Databases (PubMed, BMC Public Health, Global Health, Cross Ref, Scopus, Web of Science, and Google Scholar) with specific keywords: “clozapine” and “ schizophrenia MESHD,” “risks” agranulocytosis MESHD” “TRS” “ bipolar affective disorder MESHD” “pregnancy” “early-onset schizophrenia MESHD” “resistance”. Study eligibility criteria: we extracted information regarding drug treatment, side effects profile, and efficacy for each trial; (3) Results: Of all the searched data we selected RCT’s, C.T.’s, reviews, systematic reviews, and meta-analyses; Data were converted and analyzed in a random-effects model. We included 45 studies, centered on six main topics in the search area: (a) treatment-resistant schizophrenia MESHD, (b) use in bipolar disorder MESHD, (c) side effects during the clozapine therapy - agranulocytosis MESHD, metabolic side effects, pharmacogenetic severity markers, dysmetabolic MESHD side effects, pulmonary embolism MESHD, seizure MESHD risk – (d) safety of clozapine in pregnancy, (e) clozapine resistance and ECT augmentation, (f) clozapine therapy and COVID-19 MESHD infection. Limitations: _______(4) Conclusions and implications of key findings: (a) The genetic vulnerability postulates predictors of severity so clozapine doses should be personalises for each patient based on pharmacogenetic testing; patients with a lower genetic risk may benefit from a more relaxed hematological monitoring schedule; (b) Pulmonary embolism MESHD associated with clozapine has a mortality rate of 36.36%, prophylactic measures for venous thromboembolism MESHD for six months after initiating therapy is mandatory; (c) Convulsive MESHD episodes are not an indication for stopping the treatment, side effect (s.e.) incidence increases with the dose, the plasma concentration of clozapine (1300 ng/ml) it is a better s. e. predictor than the dosage; (d) clozapine refractory improves up to 69% early-onset schizophrenia MESHD, assesed by the Brief Psychiatric Rating Scale (BPRS) (e) more pharmacogenetic studies of the Romanian schizophrenic MESHD patients are needed in relation with the clozapine therapy in order to define more precise safety margins; (f) COVID-19 MESHD infection may enhance clozapine toxicity MESHD generating an increased risk of pneumonia MESHD therapy must be continued with proper monitoring of the white blood count and with the decrease of the clozapine dose by half until three days after the subside of the fever MESHD; psychiatrists and healthcare providers must act togheder. As in the past four decades, research has failed to generate effective novel psycho-pharmaceuticals, there is an urgent need to enhance the access to clozapine for people with TRS at the worldwide level. The progress of pharmacogenetic researches, endocrinology, genetic testing - offer the psychiatrists nowadays the chance to use this drug at its highest potential in a personalized manner for every patient - minimizing the adverse side-effects.

    Immediate Effects of COVID-19 MESHD Outbreak on Psychiatric Outpatients: Posttraumatic Stress and Influencing Factors

    Authors: Burc Cagri Poyraz; Cana Aksoy Poyraz; Senol Turan; Omer Faruk Demirel; Yasin Kavla; Ersel Bulu; Irem Hacisalihoglu; Elif Burcu Ersungur

    doi:10.1101/2020.08.12.20173468 Date: 2020-08-14 Source: medRxiv

    We aimed to investigate the effects of COVID-19 MESHD outbreak and public health measures on the psychological well-being of patients with psychiatric disorders MESHD. This cross-sectional study assessed 436 outpatients recruited from a tertiary psychiatry clinic in Istanbul, Turkey, nearly one month after the government introduced strict measures of lockdown against the ongoing outbreak. Respondents completed a web-based survey on sociodemographic data, subjective sleep quality, and a range of psychiatric MESHD symptoms using the Impact of Events Scale-Revised (IES-R), and Hospital Anxiety and Depression MESHD Scale (HADS). Respondents reported high frequencies of clinically significant posttraumatic stress disorder MESHD ( PTSD MESHD) (32.6%, IES-R score equal to or above 33), anxiety MESHD (36.4%, HADS anxiety MESHD score > 10), and depression MESHD (51%, HADS depression MESHD score > 10). 20.5% of respondents described that their psychological status worsened during the COVID-19 MESHD outbreak, and 12.1% of respondents described poor or very poor sleep in the prior month. Positive predictors of increased PTSD MESHD symptoms included the chronic medical diseases, knowing someone in the social vicinity diagnosed with the COVID-19 MESHD infection, job loss MESHD or being on temporary leave after the outbreak, and increased exposure time to TV or social media. In contrast, male gender, older age, higher educational attainment, and the psychiatric MESHD diagnoses of schizophrenia MESHD and (to a lesser degree) bipolar disorder MESHD were the negative predictors. Our results suggest that patients with psychiatric disorders MESHD are prone to substantial psychological distress during the COVID-19 MESHD outbreak, and various individual, behavioral, and social factors mediate this effect.

    Bipallidal Lesions in a COVID-19 MESHD Patient: A Case Report and Brief Review of Literature

    Authors: Sudhat Ashok; Kalyan Shastri; L. Beryl Guterman; Lee R. Guterman

    doi:10.21203/rs.3.rs-34525/v1 Date: 2020-06-09 Source: ResearchSquare

    BackgroundAltered mentation in COVID-19 MESHD patients can be a function of any number of metabolic abnormalities MESHD associated with the infection. Here we present the case of an encephalopathic COVID-19 MESHD patient with bilateral globus pallidus lesions. While imaging abnormalities involving basal ganglia MESHD have been reported in encephalitis MESHD caused by neuroinvasive flaviviruses, the bipallidal lesions noted here likely resulted from hypoxic-ischemic brain injury MESHD.Case PresentationA 51-year-old African American woman was found unresponsive at home by her fiancé. She had been complaining of shortness of breath MESHD and cough for three days. She is a former smoker with past medical history of hypertension MESHD, nephropathy MESHD, and bipolar disorder MESHD. Upon examination, she was alert but nonverbal, following commands inconsistently, and unable to move extremities against gravity. After several minutes, she was able to state her name but kept repeating it in response to all questions. Chest radiograph revealed bilateral lung infiltrates. CT of the head showed hypodensities in bilateral globus pallidi. A non-contrast MRI of the brain showed symmetric restricted diffusion and FLAIR hyperintense signal changes in bilateral globus pallidi. Abnormal SWI signal seen in bilateral globus pallidi likely represents mineralization or hemosiderin. There were no striatal or thalamic lesions. Major intracranial arteries were widely patent.The patient later tested positive for 2019-nCoV using real-time PCR assay, and was transferred to our COVID-19 MESHD designated hospital campus. Thereafter, she had waxing and waning mentation. Repeat CT imaging 11 days after the first scan demonstrated resolution of the bipallidal hypodensities. The patient was recently discharged to a subacute rehab facility but is still experiencing confusion MESHD.ConclusionsAs we come across neurological manifestations of COVID-19 MESHD, we believe neuroimaging is likely to play an important role in establishing if central nervous system involvement is invariably due to indirect mechanisms such as metabolic or hypoxic-ischemic brain injury MESHD or if direct neuroinvasive disease MESHD is a possibility, as with certain viruses.

    Bioinformatics approaches to understand the interactions between the SARS corona Virus (SARS-CoV19) with stranded drugs of anti-retro viral treatment, Influenza and Malaria.

    Authors: Santhoshi Rani Nanchari; Shyam perugu

    doi:10.21203/rs.3.rs-20010/v1 Date: 2020-03-28 Source: ResearchSquare

    Background: Severe acute respiratory syndrome MESHD (SARS) is highly contagious disease caused by virus COVID19 MESHD. The first case is reported in Wuhan, China, with rapid spreading all over the world and the rate of mortality is also high. SARS-CoV MESHD and another human coronavirus, HCoV-NL63 has large spike protein (S PROTEIN) on the virion surface mediates both cell attachment and membrane fusion with receptor sites present on host cell-surface zinc peptidase, angiotensin-converting enzyme 2 (ACE2). Methodology: In the present study, molecular docking studies have been carried out to assess the interaction between the novel corona virus protein COVID19 MESHD with stranded drugs used for influenza, anti-retro viral therapy and malaria MESHD drugs by using Accelerys discovery studio 2.5, followed by analysis of data. The present study will help to design the drugs against the corona virus and understand the mode of treatment for SARS. Results: All the four-protein receptor of COVID 19 proteins at particular amino acid position binds to the NH and H atom of anti-retro viral therapy drugs (Atazanavir, Doravirine, Emitricitabine, Entravirine, Raltegravir, Tenofavir Disproxil, and Zidovudin) and anti- malaria MESHD drug (Hydroxy chloroquine) with less hydrogen bond distance with maximum docking scores which indicates that these compounds can acts against the COVID19 MESHD virus. Gene mania MESHD network help to design the novel drugs and diagnosis. Conclusions: This is first report to show the molecular docking interaction between the COVID19 MESHD protein with stranded drugs of anti -viral treatment. anti-viral drugs Atazanavir, Doravirine, Emitricitabine, Entravirine, Raltegravir, Tenofavir Disproxil, and Zidovudin and malaria drug Hydroxy MESHD chloroquine has more strong binding with COVID19 MESHD protein receptors.

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MeSH Disease
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