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Acute and Chronic Neuropsychiatric Sequelae of COVID-19
Please join us for the live review of this session at 2:45 PM EST on Thu Nov 11:
https://clp21.secure-platform.com/a/solicitations/8/sessiongallery/schedule/items/116
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Since March 2020, consultation-liaison psychiatrists around the world have dedicated a large portion of their efforts towards caring for patients with COVID-19 and studying the neuropsychiatric effects of the illness. In the acute infection stage, rates of delirium approach 80% in some populations, and non-delirium psychosis is emerging as an important phenomenon as well. Novel presentations are also being described, including a cluster of symptoms that resembles akinetic mutism and other reports of catatonia successfully treated with benzodiazepines. As the pandemic has continued, survivors are being characterized as having high rates of depression, anxiety and PTSD. A phenomenon of Long COVID has also emerged, characterized by ongoing fatigue, subjective brain fog, and, recently, some objective deficits in executive function on neuropsychological testing. Many of these patients initially only experienced mild illness not requiring hospitalization, but their symptoms have persisted for weeks or months, refractory to medication interventions. In this workshop, we will present an overview of acute and chronic neuropsychiatric complications of infection with SARS-CoV-2. All presenters are actively involved in research related to COVID and will present their own findings and observations in addition to reviewing the literature. Scott Beach, MD, is the Program Director for the MGH/McLean Adult Psychiatry Residency and an attending psychiatrist on the MGH CL service. He has published several articles characterizing delirium in the COVID+ population. He will review acute neuropsychiatric complications of COVID, discuss imaging and laboratory findings in patients with “neuroCOVID” and highlight some unusual symptoms seen in COVID delirium, including akinetic mutism. Erica Baller, MD, is an inpatient CL psychiatrist at the University of Pennsylvania and a post-doc in neuropsychiatry. She has published on the management of COVID delirium. Dr. Baller will review potential pathophysiological mechanisms for involvement of the central nervous system by the SARS-CoV-2 virus and will discuss an algorithmic approach to managing delirium in the setting of COVID-19, with particular attention paid to ways in which this might differ from standard delirium management. Christian Hicks, MD, is a CL Fellow at Columbia University and is currently working with a behavioral neurologist to provide care with post-acute sequelae of COVID. Dr. Hicks will review clinical findings and phenomenology of Long-COVID, in addition to discussing potential treatment modalities. Davin Quinn, MD, is Vice Chair for Adult Clinical Services and a CL psychiatrist at the University of New Mexico who is currently studying neurodiagnostics, including EEG, FNIRS and fMRI in patients with chronic cognitive symptoms after COVID. He will present some preliminary data as well as review possible pathophysiology and suggested workup for patients with Long COVID.
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Since March 2020, consultation-liaison psychiatrists around the world have dedicated a large portion of their efforts towards caring for patients with COVID-19 and studying the neuropsychiatric effects of the illness. In the acute infection stage, rates of delirium approach 80% in some populations, and non-delirium psychosis is emerging as an important phenomenon as well. Novel presentations are also being described, including a cluster of symptoms that resembles akinetic mutism and other reports of catatonia successfully treated with benzodiazepines. As the pandemic has continued, survivors are being characterized as having high rates of depression, anxiety and PTSD. A phenomenon of Long COVID has also emerged, characterized by ongoing fatigue, subjective brain fog, and, recently, some objective deficits in executive function on neuropsychological testing. Many of these patients initially only experienced mild illness not requiring hospitalization, but their symptoms have persisted for weeks or months, refractory to medication interventions. In this workshop, we will present an overview of acute and chronic neuropsychiatric complications of infection with SARS-CoV-2. All presenters are actively involved in research related to COVID and will present their own findings and observations in addition to reviewing the literature. Scott Beach, MD, is the Program Director for the MGH/McLean Adult Psychiatry Residency and an attending psychiatrist on the MGH CL service. He has published several articles characterizing delirium in the COVID+ population. He will review acute neuropsychiatric complications of COVID, discuss imaging and laboratory findings in patients with “neuroCOVID” and highlight some unusual symptoms seen in COVID delirium, including akinetic mutism. Erica Baller, MD, is an inpatient CL psychiatrist at the University of Pennsylvania and a post-doc in neuropsychiatry. She has published on the management of COVID delirium. Dr. Baller will review potential pathophysiological mechanisms for involvement of the central nervous system by the SARS-CoV-2 virus and will discuss an algorithmic approach to managing delirium in the setting of COVID-19, with particular attention paid to ways in which this might differ from standard delirium management. Christian Hicks, MD, is a CL Fellow at Columbia University and is currently working with a behavioral neurologist to provide care with post-acute sequelae of COVID. Dr. Hicks will review clinical findings and phenomenology of Long-COVID, in addition to discussing potential treatment modalities. Davin Quinn, MD, is Vice Chair for Adult Clinical Services and a CL psychiatrist at the University of New Mexico who is currently studying neurodiagnostics, including EEG, FNIRS and fMRI in patients with chronic cognitive symptoms after COVID. He will present some preliminary data as well as review possible pathophysiology and suggested workup for patients with Long COVID.
Speakers
Scott Beach
Program Director | Massachusetts General Hospital
Dr. Scott R. Beach is the Program Director for the MGH/McLean Adult Psychiatry Residency, an attending psychiatrist on the MGH Psychiatry Consultation and Acute Psychiatric Services, and an Associate Professor of Psychiatry at Harvard Medical School. He attended the University of Virginia School of Medicine and completed a residency in Adult Psychiatry at the University of Virginia. He finished a fellowship in Consultation-Liaison Psychiatry at the Massachusetts General Hospital in 2011 and was awarded Dupont-Warren and Livingston research fellowships through HMS. Dr. Beach has developed clinical and scholarly areas of expertise in QT prolongation and psychiatric medications, catatonia and related syndromes, neuropsychiatric effects of COVID-19, and deception syndromes.
Davin Quinn
Vice Chair, Adult Clinical Services | University of New Mexico School of Medicine
Davin Quinn MD, FACLP is the Vice Chair for Adult Clinical Services in the Department of Psychiatry and Behavioral Sciences at the University of New Mexico Health Sciences Center. He is quadruple-board certified in adult psychiatry, consultation-liaison psychiatry, behavioral neurology/neuropsychiatry, and brain injury medicine. He is the coordinating principal investigator for several federally funded clinical trials of brain stimulation for chronic TBI, and the director of the UNM Transcranial Magnetic Stimulation Service. Dr. Quinn's areas of interest include the diagnosis and treatment of traumatic brain injury, and the use of noninvasive neuromodulation to treat neuropsychiatric disorders.
Christian Hicks Puig
C-L Fellow | Columbia University
Dr. Hicks studied biological engineering at Cornell University and went on to study medicine at the Medical University of South Carolina. In medical school he was selected to participate in the NIH Medical Research Scholars Program where he spent a year studying connectomics in the lab of Kevin Briggman of NINDS. He completed his psychiatry residency at Columbia University where he also served as chief resident in his final year. He is currently a CL Fellow also at Columbia University where he has continued to develop his interests in cultural psychiatry and neuropsychiatry. In his final semester of fellowship he is providing psychiatric consultation to a neurology clinic studying and caring for patients with post-acute sequelae of SARS-CoV-2.
Erica Baller
Attending Psychiatrist; NRSA T32 Postdoctoral Fellow | University of Pennsylvania
Erica Baller, MD, MS is a Consultation-Liaison Psychiatrist and NRSA T32 Postdoctoral Fellow in Neuropsychiatry at the University of Pennsylvania. She graduated from Yale College with a degree in Computer Science and Psychology, with a special focus in artificial intelligence. After 5 years as a research fellow at the NIH studying the neural correlates of gonadal steroid hormones, she completed medical school at Drexel. She completed the research-track residency at the University of Pennsylvania. During her residency, she was awarded the National Neuroscience Curriculum Initiative Scholar, the Webb Fellowship, the NIMH Outstanding Resident Award, and the APA Research Colloquium for Junior Investigators Award. She graduated from CL fellowship at MGH in 2020 and was lead author on the Psychosomatics article: "Neurocovid: Pharmacologic recommendations for delirium associated with COVID-19." Her current research combines multimodal neuroimaging and informatics to study neuropsychiatric syndromes. Her work has been published in the American Journal of Psychiatry, Molecular Psychiatry, Biological Psychiatry, Neuropsychopharmacology, Psychosomatics and JAMA Open Network.
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