Neuropsychiatric manifestations in COVID-19 patients with mucormycosis presenting to tertiary care center- cross-sectional study

Authors

  • Fakirappa Ganiger Senior Resident, Gadag Institute of Medical Sciences, Gadag
  • Jitendra Mugali Associate Professor, Gadag Institute of Medical Sciences, Gadag
  • Somashekhar Bijjal Associate Professor & HOD, Gadag Institute of Medical Sciences, Gadag
  • Ashitha R Junior Resident, Gadag Institute of Medical Sciences, Gadag
  • Anirudh B Junior Resident, Gadag Institute of Medical Sciences, Gadag

DOI:

https://doi.org/10.30834/KJP.34.2.2022.302

Keywords:

COVID 19, Mucormycosis, Neuropsychiatric Manifestations, Depressive Disorders, Anxiety

Abstract

Background: Corona Virus Disease 2019 (COVID-19) pandemic has caused disruption of mental health along with physical illness, and it is associated with social and occupational impairment. Co-morbid mucormycosis in COVID-19 has added to the severity of psychiatric symptoms. Objectives: Primary objective was to assess neuropsychiatric manifestations in COVID-19 patients with mucormycosis. The secondary objective was to assess concerns for psychiatric symptoms. Materials and Methods: A cross-sectional study was done on COVID-19 patients with mucormycosis. A consecutive sampling method was adopted, and 70 COVID-19 patients with mucormycosis were recruited to the present study. Mini International Neuropsychiatry Interview Plus (M.I.N.I. Plus) was used to screen psychiatric symptoms, and the diagnosis was made as per the International Classification of Diseases tenth revision (ICD-10). Beck depression inventory (B.D.I.), Hamilton scale for assessment of anxiety (HAM-A) and Beck suicide inventory (B.S.I.) were used to assess the severity of symptoms. Results: Prevalence of neuropsychiatric manifestations in the present study was 64.28%, among which 28.8% had Major depressive episodes, 40% had anxiety, 11% had substance use disorder, and 20% had delirium. The major concern for symptoms was found to be the uncertainty of outcome, which was present in 29% of patients, followed by fear of death (25%), postoperative complications (19%), lack of knowledge (3%) and 22% of patients had multiple concerns. Conclusion: Prevalence of neuropsychiatric disorders is higher in COVID-19 patients with Mucormycosis. Psychiatric screening should be considered in these patients to decrease morbidity and improve outcome and quality of life.

Keywords: COVID-19, MINI-Plus, Major depressive episode, Anxiety, Mucormycosis.

References

Coronavirus disease 2019 (COVID-2019). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/index.html. Accessed May 30, 2021.

Coronavirus disease (COVID-19) outbreak. World Health Organization. https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed May 30, 2020.

Wu T, Jia X, Shi H, Niu J, Yin X, Xie J, et al. Prevalence of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis. J Affect Disord. 2021 Feb 15;281:91–8.

Pulvirenti F, Cinetto F, Milito C, Bonanni L, Pesce AM, Leodori G, et al. Health-Related Quality of Life in Common Variable Immunodeficiency Italian Patients Switched to Remote Assistance During the COVID-19 Pandemic. J allergy Clin Immunol Pract. 2020 Jun;8(6):1894-1899.e2.

Taquet M, Luciano S, Geddes JR, Harrison PJ. Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. The Lancet Psychiatry. 2021 Feb 1;8(2):130–40

Lee SW, Yang JM, Moon SY, Yoo IK, Ha EK, Kim SY, et al. Association between mental illness and COVID-19 susceptibility and clinical outcomes in South Korea: a nationwide cohort study. The lancet Psychiatry. 2020 Dec;7(12):1025–31.

Singh, A. K., Singh, R., Joshi, S. R., & Misra, A. (2021). Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India. Diabetes & metabolic syndrome, 15(4), 102146. Advance online publication.

Hasan MK, Kabir H, Rahman M, Roy AK, Akter S, Mitra DK. Predictors of black fungus fear during the COVID-19 pandemic among the Bangladeshi health workers: a cross-sectional study. medRxiv. 2021;

Sheehan D V, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, et al. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22–57.

Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev. 1988;8(1):77–100

Beck RW, Morris JB, Beck AT. Cross-validation of the Suicidal Intent Scale. Psychol Rep. 1974 Apr;34(2):445-6

Thompson E. Hamilton Rating Scale for Anxiety (HAM-A). Occup Med (Chic Ill). 2015;65(7):601.

Murthy RS. National Mental Health Survey of India 2015-2016. Vol. 59, Indian journal of psychiatry. 2017. p. 21–6.

Latif A, Shamsher Khan RM, Nawaz K. Depression and anxiety in patients undergoing elective and emergency surgery: Cross-sectional study from Allama Iqbal Memorial Teaching Hospital, Sialkot. J Pak Med Assoc. 2017 Jun;67(6):884-888.

Zhang Z, Feng Y, Song R, Yang D, Duan X. Prevalence of psychiatric diagnosis and related psychopathological symptoms among patients with COVID-19 during the second wave of the pandemic. Global Health. 2021 Apr;17(1):44.

Roden MM, Zaoutis TE, Buchanan WL, Knudsen TA, Sarkisova TA, Schaufele RL, et al. Epidemiology and outcome of zygomycosis: a review of 929 reported cases. Clin Infect Dis an Off Publ Infect Dis Soc Am. 2005 Sep;41(5):634–53.

A.K. AK, Gupta V. Rhino-orbital Cerebral Mucormycosis. [Updated 2021 May 1]. In: StatPearls [Internet]. Treasure Island (F.L.): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557429.

Davis GE, Yueh B, Walker E, Katon W, Koepsell TD, Weymuller EA. Psychiatric distress amplifies symptoms after surgery for chronic rhinosinusitis. Otolaryngol Head Neck Surg. 2005 Feb;132(2):189-96.

Skiada A, Pagano L, Groll A, Zimmerli S, Dupont B, Lagrou K, et al. Zygomycosis in Europe: analysis of 230 cases accrued by the registry of the European Confederation of Medical Mycology (ECMM) Working Group on Zygomycosis between 2005 and 2007. Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis. 2011 Dec;17(12):1859–67.

Hull AM, Lowe T, Devlin M, Finlay P, Koppel D, Stewart AM. Psychological consequences of maxillofacial trauma: a preliminary study. Br J Oral Maxillofac Surg. 2003 Oct;41(5):317–22.

Choudhury-Peters D, Dain V. Developing psychological services following facial trauma. BMJ Qual Improv reports. 2016;5(1).

Vijayakumar B, Elango P, Ganessan R. Post-operative delirium in elderly patients. Indian J Anaesth. 2014 May;58(3):251–6.

Chikley A, Ben-Ami R, Kontoyiannis DP. Mucormycosis of the Central Nervous System. J fungi (Basel, Switzerland). 2019 Jul;5(3).

Thomas RI, Cameron DJ, Fahs MC. A prospective study of delirium and prolonged hospital stay. Exploratory study. Arch Gen Psychiatry. 1988 Oct;45(10):937-40.

Ghaeli P, Shahhatami F, Mojtahed Zade M, Mohammadi M, Arbabi M. Preventive Intervention to Prevent Delirium in Patients Hospitalized in Intensive Care Unit. Iran J Psychiatry. 2018 Apr;13(2):142–7.

Downloads

Published

2022-01-02

How to Cite

Ganiger, F. ., Mugali, J., Bijjal, S., Ashitha, R., & Anirudh, B. (2022). Neuropsychiatric manifestations in COVID-19 patients with mucormycosis presenting to tertiary care center- cross-sectional study. Kerala Journal of Psychiatry, 34(2), 149–154. https://doi.org/10.30834/KJP.34.2.2022.302

Issue

Section

Research Report