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Delirium in patients with COVID-19 treated in the intensive care unit

Jae Hoon Lee1, Won Ho Han1, June Young Chun2

  • 1Critical Care Medicine, National Cancer Center, Goyang, South Korea.

Plos One
|November 13, 2023
PubMed

Insights

Delirium in COVID-19 patients is linked to older age, hypertension, and mechanical ventilation. Identifying these risk factors in intensive care units (ICUs) can help prevent and treat delirium, improving patient outcomes.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Neurology

Background:

  • Coronavirus disease 2019 (COVID-19) can cause acute organ dysfunction.
  • Delirium in critically ill patients is associated with adverse outcomes, including prolonged hospitalization and long-term cognitive impairment.
  • Understanding risk factors for delirium in COVID-19 patients admitted to the intensive care unit (ICU) is crucial for timely intervention.

Purpose of the Study:

  • To investigate the risk factors associated with delirium development in intensive care unit (ICU) patients with COVID-19 pneumonia.
  • To identify demographic, clinical, and treatment-related factors that predict delirium in this patient population.

Main Methods:

  • Retrospective single-center study including 111 adult patients with COVID-19 pneumonia requiring oxygen therapy.
  • Data collected from electronic health records included demographics, medical history, disease severity (Sequential Organ Failure Assessment score), and treatment strategies.
  • Statistical analysis, including univariable and multivariable logistic regression, was used to identify significant risk factors for delirium.

Main Results:

  • Univariable analysis identified old age, hypertension, higher Sequential Organ Failure Assessment scores, mechanical ventilator support, neuromuscular blocker use, and longer ICU length of stay as significant factors.
  • Multivariable analysis confirmed old age, hypertension, mechanical ventilator support, and longer ICU length of stay as independent predictors of delirium.
  • Specific risk factors identified include old age (OR 1.149), hypertension (OR 8.651), mechanical ventilation (OR 226.215), and ICU length of stay (OR 30.295).

Conclusions:

  • Older age, hypertension, need for mechanical ventilation, and prolonged ICU stay are significant risk factors for delirium in COVID-19 patients.
  • These findings highlight the importance of early identification and management strategies for delirium in critically ill COVID-19 patients.
  • Proactive measures to predict and prevent delirium in this vulnerable population are warranted.

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