Your browser doesn't support javascript.
Delirium in hospitalized COVID-19 patients: Predictors and implications for patient outcome.
Wilke, Vera; Sulyok, Mihaly; Stefanou, Maria-Ioanna; Richter, Vivien; Bender, Benjamin; Ernemann, Ulrike; Ziemann, Ulf; Malek, Nisar; Kienzle, Katharina; Klein, Constantin; Bunk, Stefanie; Goepel, Siri; Mengel, Annerose.
  • Wilke V; Department of Neurology and Stroke, University Hospital Tuebingen, Tuebingen, Germany.
  • Sulyok M; Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.
  • Stefanou MI; Department of Pathology and Neuropathology, Eberhard Karls University of Tuebingen, Tuebingen, Germany.
  • Richter V; Second Department of Neurology, Medical School, National and Kapodistrian University of Athens, 'Attikon' University General Hospital, Athens, Greece.
  • Bender B; Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Tuebingen, Germany.
  • Ernemann U; Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Tuebingen, Germany.
  • Ziemann U; Department of Diagnostic and Interventional Neuroradiology, University Hospital Tuebingen, Tuebingen, Germany.
  • Malek N; Department of Neurology and Stroke, University Hospital Tuebingen, Tuebingen, Germany.
  • Kienzle K; Hertie-Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.
  • Klein C; Department of Internal Medicine I, University Hospital of Tuebingen, Tuebingen, Germany.
  • Bunk S; Clinical Research Unit Tuebingen, German Center of Infectious Diseases (DZIF), Brunswick, Germany.
  • Goepel S; Department of Internal Medicine I, University Hospital of Tuebingen, Tuebingen, Germany.
  • Mengel A; Department of Internal Medicine I, University Hospital of Tuebingen, Tuebingen, Germany.
PLoS One ; 17(12): e0278214, 2022.
Article in English | MEDLINE | ID: covidwho-2197039
ABSTRACT

INTRODUCTION:

Delirium is recognized as a severe complication of coronavirus-disease-2019 (COVID-19). COVID-19-associated delirium has been linked to worse patient outcomes and is considered to be of multifactorial origin. Here we sought to evaluate the incidence and risk factors of delirium in hospitalized COVID-19 patients, along with its impact on clinical outcome.

METHODS:

Consecutive adult COVID-19 patients admitted to a tertiary academic referral hospital between March 1st and December 31st, 2020 were included. Potential risk factors for delirium were evaluated, including age, gender, disease severity (as per the highest WHO grading reached during admission), laboratory parameters for infection and renal function (as per their most extreme values), and presence of comorbidities. To assess the relative strength of risk factors for predicting the occurrence of delirium, we performed a random-forest survival analysis.

RESULTS:

347 patients with positive COVID-19 PCR test and median age 68.2 [IQR 55.5, 80.5] years were included. Of those, 79 patients (22.8%) developed delirium, 81 (23.3%) were transferred to ICU, 58 (16.7%) died. 163 (73.8%) patients were discharged home, 13 (5.9%) to another hospital, 32 (14.5%) to nursing homes, 13 (5.9%) to rehabilitation with an overall median admission-to-discharge time of 53 [IQR 14, 195] days. The strongest predictors for the occurrence of delirium were blood urea nitrogen (minimal depth value (MD) 3.33), age (MD 3.75), disease severity (as captured by WHO grading; MD 3.93), leukocyte count (MD 4.22), the presence of a neurodegenerative history (MD 4.43), ferritin (MD 4.46) and creatinine (MD 4.59) levels.

CONCLUSION:

The risk of delirium in COVID-19 can be stratified based on COVID-19 disease severity and-similar to delirium associated with other respiratory infections-the factors advanced age, neurodegenerative disease history, and presence of elevated infection and renal-retention parameters. Screening for these risk factors may facilitate early identification of patients at high-risk for COVID-19-associated delirium.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Neurodegenerative Diseases / Delirium / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Humans Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0278214

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Neurodegenerative Diseases / Delirium / COVID-19 Type of study: Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Topics: Long Covid Limits: Adult / Aged / Humans Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2022 Document Type: Article Affiliation country: Journal.pone.0278214