Delirium occurrence and association with outcomes in hospitalized COVID-19 patients
- 23 September 2021
- journal article
- research article
- Published by Cambridge University Press (CUP) in International Psychogeriatrics
- Vol. 33 (10), 1105-1109
- https://doi.org/10.1017/s104161022100106x
Abstract
Delirium is reported to be one of the manifestations of coronavirus infectious disease 2019 (COVID-19) infection. COVID-19 hospitalized patients are at a higher risk of delirium. Pathophysiology behind the association of delirium and COVID-19 is uncertain. We analyzed the association of delirium occurrence with outcomes in hospitalized COVID-19 patients, across all age groups, at Mayo Clinic hospitals. A retrospective study of all hospitalized COVID-19 patients at Mayo Clinic between March 1, 2020 and December 31, 2020 was performed. Occurrence of delirium and outcomes of mortality, length of stay, readmission, and 30-day mortality after hospital discharge were measured. Chi-square test, student t-test, survival analysis, and logistic regression analysis were performed to measure and compare outcomes of delirium group adjusted for age, sex, Charlson comorbidity score, and COVID-19 severity with no-delirium group. A total of 4351 COVID-19 patients were included in the study. Delirium occurrence in the overall study population was noted to be 22.4%. The highest occurrence of delirium was also noted in patients with critical COVID-19 illness severity. A statistically significant OR 4.35 (3.27–5.83) for in-hospital mortality and an OR 4.54 (3.25–6.38) for 30-day mortality after discharge in the delirium group were noted. Increased hospital length of stay, 30-day readmission, and need for skilled nursing facility on discharge were noted in the delirium group. Delirium in hospitalized COVID-19 patients is a marker for increased mortality and morbidity. In this group, outcomes appear to be much worse when patients are older and have a critical severity of COVID-19 illness.This publication has 9 references indexed in Scilit:
- Predicting Delirium Risk Using an Automated Mayo Delirium Prediction ToolMayo Clinic Proceedings, 2021
- Prevalence and risk factors for delirium in critically ill patients with COVID-19 (COVID-D): a multicentre cohort studyThe Lancet Respiratory Medicine, 2021
- The chronic neuropsychiatric sequelae of COVID‐19: The need for a prospective study of viral impact on brain functioningAlzheimer's & Dementia, 2021
- Delirium in Older Patients With COVID-19 Presenting to the Emergency DepartmentJAMA Network Open, 2020
- Ascertainment of Delirium Status Using Natural Language Processing From Electronic Health RecordsThe Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 2020
- Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patientsCritical Care, 2020
- Delirium as a presenting feature in COVID-19: Neuroinvasive infection or autoimmune encephalopathy?Brain, Behavior, and Immunity, 2020
- Delirium in COVID-19: A case series and exploration of potential mechanisms for central nervous system involvementGeneral Hospital Psychiatry, 2020
- Delirium in the ElderlyClinics in Geriatric Medicine, 2020