The impact of delirium on outcomes for older adults hospitalised with COVID-19.
Age Ageing
; 49(6): 923-926, 2020 10 23.
Article
in English
| MEDLINE | ID: covidwho-727029
ABSTRACT
INTRODUCTION:
Delirium is a frequent condition in hospitalized older patients and it usually has a negative prognostic value. A direct effect of SARS-COV-2 on the central nervous system (CNS) has been hypothesized.OBJECTIVE:
To evaluate the presence of delirium in older patients admitted for a suspected diagnosis of COVID-19 and its impact on in-hospital mortality. SETTING ANDSUBJECTS:
91 patients, aged 70-years and older, admitted to an acute geriatric ward in Northern Italy from March 8th to April 17th, 2020.METHODS:
COVID-19 cases were confirmed by reverse transcriptase-polymerase chain reaction assay for SARS-Cov-2 RNA from nasal and pharyngeal swabs. Delirium was diagnosed by two geriatricians according to the Diagnostic and Statistical Manual of Mental Disorders V (DMS V) criteria. The number of chronic diseases was calculated among a pre-defined list of 60. The pre-disease Clinical Frailty Scale (CFS) was assessed at hospital admission.RESULTS:
Of the total sample, 39 patients died, 49 were discharged and 3 were transferred to ICU. Twenty-five patients (27.5%) had delirium. Seventy-two percent of patients with delirium died during hospitalization compared to 31.8% of those without delirium. In a multivariate logistic regression model adjusted for potential confounders, patients with delirium were four times more likely to die during hospital stay compared to those without delirium (OR = 3.98;95%CI = 1.05-17.28; p = 0.047).CONCLUSIONS:
Delirium is common in older patients with COVID-19 and strongly associated with in-hospital mortality. Regardless of causation, either due to a direct effect of SARS-COV-2 on the CNS or to a multifactorial cause, delirium should be interpreted as an alarming prognostic indicator in older people.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Coronavirus Infections
/
Delirium
/
Betacoronavirus
/
Frailty
/
Hospitals
Type of study:
Experimental Studies
/
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
Europa
Language:
English
Journal:
Age Ageing
Year:
2020
Document Type:
Article
Affiliation country:
Ageing
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