[An impact of the COVID-19 pandemia on the onset and course of mental disorders in elderly].

OBJECTIVE

To study the impact of COVID-19 on the onset and course of mental disorders in hospitalized elderly patients.

MATERIAL AND

METHODS

We studied 67 inpatients, aged 50 to 95 years, with various mental illnesses in accordance with the ICD-10 criteria, who underwent COVID-19 from February 2020 to December 2021. Forty-six people were previously mentally ill, in 21 cases the disease developed for the first time.

RESULTS

The group of primary diseased patients was dominated by depressive episodes (F32, (42.9%), including psychotic episodes (9.5%). In 28.6% of cases, organic disorders were diagnosed in the form of emotional lability (F06.6), organic depression (F06.3), mild cognitive impairment (F06.7) and delirium (F05.86). In 23.8% of patients, neurotic disorders were observed in the form of depressive reactions (F43), panic (F41.0) and generalized anxiety disorder (F41.1). In one case (4.8%), acute polymorphic psychosis with symptoms of schizophrenia (F23.1) was diagnosed. The diagnoses of the previously mentally ill group were: affective disorders (F31, F32, F33 - 45.7%); organic disorders, including dementia (F06.3, F06.7, F00.1, F00.2 - 26.1%); schizophrenia spectrum disorders (F25, F21, F22, F20.01 - 19.6%), and neurotic somatoform disorders (F45 - 8.7%). In the acute and subacute periods of COVID-19 (≤3 months), acute psychotic states (APS) developed in both groups of patients (in 23.3% and 30.4%, respectively) in the form of delirium, psychotic depression, or polymorphic psychosis. APS were more common in mentally ill patients with organic (50%) and schizophrenia spectrum (33.3%) disorders with a predominance of delirium. In the long-term period of COVID-19, mentally ill patients more often than primary diseased patients (60.9% and 38.1%) developed cognitive impairment (CI), especially in schizophrenic (77.8%) and organic (83.3%) disorders. CI developed twice as often after APS (89.5% and 39.6%, p<0.001), reaching the degree of dementia in 15.8% of cases. APS were significantly associated (p<0.05) with the development of CI (0.567733), the age of patients (0.410696) and the presence of previous cerebrovascular insufficiency (0.404916).

CONCLUSION

The age-related features of the mental consequences of COVID-19 are the occurrence of APS in the acute period of infection and the deterioration of cognitive activity at a remote stage. The mentally ill, especially those of the organic and schizophrenia spectrum, were found to be more vulnerable to the effects of COVID-19. In them, the occurrence of APS was a risk factor for the development of dementia, while in primary diseased, affective and neurotic patients, CI was reversible or had the character of a mild cognitive disorder.