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Investigación y educación

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Consensus of the Liaison-Psychiatry Committee of the Colombian Psychiatric Association on the diagnosis and treatment of delirium in the context of the COVID-19 pandemic. Rev Colomb Psiquiatr (Engl Ed).
Investigación y Educación web_11

Abstract

The pandemic caused by the new coronavirus named SARS-CoV-2 poses unprecedented challenges in the health care. Among them is the increase in cases of delirium. The severe SARS-CoV-2 disease, COVID-19, has common vulnerabilities with delirium and produces alterations in organs such as the lungs or the brain, among others, which have the potential to trigger the mental disorder. In fact, delirium may be the first manifestation of the infection, before fever, general malaise, cough or respiratory disturbances. It is widely supported that delirium increases the morbidity and mortality in those who suffer from it during hospitalization, so it should be actively sought to carry out the relevant interventions. In the absence of evidence on the approach to delirium in the context of COVID-19, this consensus was developed on three fundamental aspects: diagnosis, non-pharmacological treatment and pharmacological treatment, in patients admitted to the general hospital. The document contains recommendations on the systematic use of diagnostic tools, when to hospitalize the patient with delirium, the application of non-pharmacological actions within the restrictions imposed by COVID-19, and the use of antipsychotics, taking into account the most relevant side effects and pharmacological interactions.

Conclusions

Given the large numbers of cases of delirium related to COVID-19 and environmental factors of isolation and potential restrictions on human and technical resources, systematic detection and monitoring of the disorder should be structured with validated tools. In all cases, the aetiology must be actively sought in order to intervene, and non-pharmacological interventions must be adapted to suit the resources available. When pharmacological interventions for delirium are necessary, adverse effects should be taken into account in light of patient profiles and drug interactions.

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