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Delirium and Post-Discharge Neuropsychological Outcomes in Critically Ill Patients with COVID-19: an Institutional Case Series (preprint)
medrxiv; 2020.
Preprint
in English
| medRxiv | ID: ppzbmed-10.1101.2020.11.03.20225466
ABSTRACT
Delirium is a serious and common complication among critically ill patients with COVID-19. The objective of this study was to characterize the clinical course of delirium for COVID-19 patients in the intensive care unit, including post-discharge cognitive outcomes. A retrospective chart review was conducted for patients diagnosed with COVID-19 (n=148) admitted to an intensive care unit at Michigan Medicine between 3/1/2020 and 5/31/2020. Delirium was identified in 107/148 (72%) patients in the study cohort, with median (interquartile range) duration lasting 10 (4 - 17) days. Sedative regimens, inflammation, deviation from delirium prevention protocols, and hypoxic-ischemic injury were likely contributing factors, and the most common disposition for delirious patients was a skilled care facility (41/148, 38%). Among patients who were delirious during hospitalization, 4/17 (24%) later tested positive for delirium at home based on caretaker assessment, 5/22 (23%) demonstrated signs of questionable cognitive impairment or cognitive impairment consistent with dementia, and 3/25 (12%) screened positive for depression within two months after discharge. Overall, patients with COVID-19 commonly experience a prolonged course of delirium in the intensive care unit, likely with multiple contributing factors. Furthermore, neuropsychological impairment may persist after discharge.
Full text:
Available
Collection:
Preprints
Database:
medRxiv
Main subject:
Myocardial Ischemia
/
Cognition Disorders
/
Delirium
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Dementia
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Depressive Disorder
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Cognitive Dysfunction
/
COVID-19
/
Inflammation
Language:
English
Year:
2020
Document Type:
Preprint
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