Related Experiment Video
Updated: Aug 7, 2025
Murine Oropharyngeal Aspiration Model of Ventilator-associated and Hospital-acquired Bacterial Pneumonia
Published on: June 28, 2018
Common Biomarkers Associated with Delirium in Hospitalized Patients with COVID-19 at the Epicentre of Turkish
Süleyman Dönmezler1, Aybegüm Uysal1, İmren Kurt1
1Başakşehir Çam ve Sakura City Hospital, Department of Psychiatry, İstanbul, Turkey.
Insights
Delirium in Coronavirus Disease 2019 (COVID-19) patients is linked to elevated urea levels and urea/creatinine ratios. Troponin-T may also play a role in the brain-heart connection observed in COVID-19 patients with delirium.
Area of Science:
- Biochemistry
- Neurology
- Infectious Diseases
Background:
- Coronavirus Disease 2019 (COVID-19) can lead to neurological complications, including delirium.
- Understanding biochemical differences in COVID-19 patients with and without delirium is crucial for patient management.
Purpose of the Study:
- To identify biochemical markers associated with delirium in non-intensive care COVID-19 patients.
- To explore potential links between cardiac markers and delirium in COVID-19.
Main Methods:
- An observational, case-control study involving 43 delirious and 45 non-delirious COVID-19 patients.
- Delirium diagnosed using DSM-5 criteria; biochemical data extracted from electronic medical records.
- Binomial and multivariate logistic regression analyses adjusted for confounding factors.
Main Results:
- Patients with delirium exhibited higher urea, d-dimer, troponin-T, and Charlson Comorbidity Index (CCI) levels.
- Lower estimated glomerular filtration rate (eGFR), serum albumin, and O2 saturation were observed in delirious patients.
- Independent predictors of delirium included elevated urea, urea/creatinine ratio, and troponin-T.
Conclusions:
- Higher urea levels and urea/creatinine ratios are associated with delirium in COVID-19 patients.
- Troponin-T may indicate a link between cardiac and neurological dysfunction in COVID-19.
- Further multi-center studies are recommended to validate these findings.
Introduction:
To investigate the differences in biochemical characteristics between Coronavirus Disease 2019 (COVID-19) patients with and without delirium in non-intensive care (IC) COVID-19 units was aimed.
Methods:
This study was designed as an observational, single-centered, and case-control study consisting of 43 delirious patients and matched 45 non-delirious patients admitted to non-IC COVID-19 units. Delirium was diagnosed by a consultant psychiatrist according to the DSM-5 delirium diagnostic criteria. Independent variables such as laboratory tests at the time of admission, clinical features, and patient characteristics were obtained from electronic medical records by researchers. In the primary analyses, binomial logistic regression models were used to investigate the factors associated with delirium, which was identified as the outcome variable. Multivariate logistic models were then adjusted for potential confounding factors, including age, gender, history of neurocognitive disorders and Charlson Comorbidity Index (CCI).
Results:
We observed higher levels of urea, d-dimer, troponin-T, proB-type natriuretic peptide, and CCI in patients with delirium compared to patients without delirium. We also observed lower levels of estimated glomerular filtration rate (eGFR), serum albumin, and O2 saturation and a decrease in the length of stay at the hospital. After adjusting for confounding factors such as gender, age, and comorbidity, we found that urea (adjusted estimate=0.015; 95% Confidence Interval [CI]=0.058-0.032, P=0.039), urea/creatinine ratio (adjusted estimate=0.008; 95% CI=0.002-0.013, P=0.011), and troponin-T (adjusted estimate=0.066; 95% CI=0.014-0.118, P=0.014) were independent biomarkers associated with delirium.
Conclusion:
Delirium is associated with higher urea levels and urea/creatinine ratios in COVID-19 patients. In addition, the relationship between troponin-T and delirium may help understand the potential link between the brain and the heart in COVID-19. Additional multi-centred studies with larger sample sizes are needed to generalise these results.
More Related Videos
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:30Acute Coronary Syndrome III: Diagnostic Studies