The Corona pandemic has kept the world on tenterhooks for two years now. The uncertainties, limitations and worries do not pass anyone by without a trace. On people with attention deficit hyperactivity disorder, however, stress can have yet another impact. Intensive care and effective treatment management are then essential.
It has been a good two years since the Wuhan Health Department reported an outbreak of severe pneumonia with acute respiratory failure. Infection rates were rising rapidly. The causative agent was quickly found and identified: SARS-CoV-2, a new corona virus. The virus spread around the world in a very short time. WHO figures from November 2021 show that more than 250 million people worldwide have been affected by corona so far – in the meantime, the situation already looks different again. The new mutation gives us an unprecedented increase. By Jan. 12, 2022, the number of infected people was already over 312 million [1]. Fortunately, the number of corona-related deaths is not increasing at the same rate. At the end of November, 5.098 million people had died, compared with 5.501 million in mid-January.
The confrontation with the disease and possible death as well as the fear of infection and possible quarantine do not pass people by without leaving a trace. They lead to social isolation, conflicts within the family, work overload and/or financial losses. This is dangerous stress from which depression, bipolar disorder, or post-traumatic stress disorder, among others, can develop [2]. This is because severe multi-organ disease is associated with cardio-respiratory manifestations as well as central nervous system impairment. Systemic inflammation as well as neuroinflammatory changes entail a massive increase in proinflammatory molecules in the brain, neuroglial reactivity, an altered neurochemical landscape, and pathological remodeling of neuronal networks.
Higher mortality and hospitalization risk
On this basis, scientists were able to detect a bidirectional relationship between corona and mental illness. The risk of mortality is doubled in people with mental illness, and the hospitalization rate is also significantly higher (27% vs. 18%) [3]. Patients with attention deficit hyperactivity disorder (ADHD) are also frequently affected. Due to stress, typical symptoms such as impulsivity and inattention become even more apparent. Results of a longitudinal study of children and adolescents conducted in Germany show that the proportion of affected individuals with mental disorders such as hyperactivity somewhat doubled during the pandemic [4]. Increased hyperactivity has also been recorded in school children in domestic quarantine in China [5]. But people with ADHD are also limited in their ability to comply with prevention measures. This increases the risk of infection – especially in untreated patients [6].
14,022 patients who underwent at least one COVID-19 test were studied. It was found that a total of 10.1% of the subjects had become infected. Strikingly, all affected individuals had higher rates of ADHD than COVID-19-negative patients. The risk of corona disease was higher in untreated ADHD sufferers compared with patients without ADHD. In contrast, no increased risk was found in treated ADHD patients [6]. This suggests that both children and adults benefit from effective and well-tolerated pharmacotherapy. The gold standard for this is considered to be methylphenidate, which can demonstrate a firm evidence base based on a broad data base.
Congress: dgppn 2021
Literature:
- https://covid19.who.int (last call on 13.01.2022)
- Steardo Jr. L, Steardo L, Verkhratsky A: Psychiatric face of COVID-19. Translational Psychiatry 2020; 10: 261.
- Wang QQ, Xu R, Volkow ND: Increased risk of COVID-19 infection and mortality in peaople with mental disorders: analysis from electromic health records in the United States. World Psychiatry 2021; 20: 124-130.
- Ravens-Sieberer U, et al: Impact oft he COVID-19 pandemic on qality of life and mental health in children and adolescents in Germany. Bundesgesundheitsbl 2021. https://doi.org/10.1007/s00103-021-03291-3
- Jiao WY, Wang LN, Liu J, et al: Behavioral and Emotional Disorders in Children during the COVID-19 Epidemic. J Pediatr. 2020; 221: 264-266.
- Merzon E, Manor I, Rotem A, et al: ADHD as a risk factor for infection with Covid-19. Journal of Attention Disorders 2020;13: 1783-1790.
InFo NEUROLOGY & PSYCHIATRY 2022; 20(1): 26-27 (published 2/1/22, ahead of print).
