Delirium severity in critical patients with COVID-19 from an Infectious Disease Intensive Care Unit

Autores da FMUP

• Andreia Filipa Gomes Da Costa

  Autor

• António Carlos Megre Eugénio Sarmento

  Autor

Participantes de fora da FMUP

• Dias, R
• Caldas, JP
• Pinto, A.
• Santos, L.

Unidades de investigação

• Medicina

• Neurociências Clínicas e Saúde Mental

Abstract

Background: COVID-19 is mainly characterized by respiratory manifestations. Nevertheless, neurologic complications have been described, including delirium, which appears to be frequent, prolonged, and severe. Methods: We conducted a retrospective analysis of demographic, clinical, and laboratory data of two cohorts: patients with COVID-19 admitted to the infectious disease intensive care unit (ID-ICU) and patients admitted to the ID-ICU with other respiratory infections in 2018-2019. Outcomes were defined as the presence, duration, and severity of delirium. Doses of antipsychotics used to control delirium were converted to equivalents and used as delirium severity. Logistics regression models were used to correlate COVID-19 with the outcomes. Results: Ninety-nine patients with COVID-19 and 40 patients without COVID-19 were included. The mean age of the COVID-19 cohort was 63 years, with a male predominance. Delirium developed in 42%, with a median duration of 3 days and an equivalent dose of olanzapine use of 10 mg/day. In univariate analysis, COVID-19 was not associated with the development or different duration of delirium when compared with patients without COVID-19. There was an association between COVID-19 and severity of delirium in a binary logistic regression model controlled to confounding variables. Conclusion: COVID-19 is not associated with a higher prevalence or duration of delirium than in cohorts without COVID-19. However, it is associated with more severe forms of delirium. (C) 2022 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.

Keywords

• Communicable Diseases; COVID-19; Delirium; Female; Humans; Intensive Care Units; Male; Middle Aged; Retrospective Studies; benzodiazepine derivative; neuroleptic agent; olanzapine; sedative agent; adult; Article; cohort analysis; confounding variable; controlled study; coronavirus disease 2019; critical illness; critically ill patient; cytomegalovirus infection; disease association; disease duration; disease severity; drug dose comparison; female; hospital admission; human; influenza A; influenza B; intensive care; intensive care psychosis; intensive care unit; legionnaire disease; leishmaniasis; major clinical study; male; middle aged; nonhuman; pneumococcal infection; pneumocystosis; prevalence; respiratory tract infection; retrospective study; Staphylococcus aureus infection; communicable disease; complication; delirium