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Risk factors for delirium in patients with COVID-19: A systematic review and meta-analysis

Ziying Wen1, Rui Ma2, Jia Chen1

  • 1Department of Postgraduate Student, Xi'an Medical University, Xi'an, Shaanxi, 710021, China; Department of Geriatrics, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China.

Neuroscience
|December 2, 2024
PubMed

Insights

This meta-analysis identified 26 predisposing and 54 precipitating factors for delirium in Coronavirus Disease 2019 (COVID-19) patients. Certain COVID-19 medications, like hydrocortisone and azithromycin, may increase delirium risk.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Delirium is a significant neurological complication of Coronavirus Disease 2019 (COVID-19), increasing morbidity and mortality, particularly in older adults.
  • No comprehensive meta-analysis previously existed to identify risk factors for COVID-19-related delirium.

Approach:

  • A systematic meta-analysis was conducted using data from 21 observational clinical studies, encompassing 10,147 patients.
  • Literature searches were performed across major databases (PubMed, Embase, Cochrane Library, Web of Science), with study quality assessed using the Newcastle-Ottawa Scale (NOS).
  • Data were extracted and pooled using fixed or random effects models based on heterogeneity testing.

Key Points:

  • The meta-analysis identified 26 predisposing factors and 54 precipitating factors associated with delirium in COVID-19 patients.
  • Specific medications used for COVID-19 treatment, including hydrocortisone and azithromycin, showed a potential positive association with delirium incidence.
  • Older patients with COVID-19 are particularly vulnerable to delirium.

Conclusions:

  • This study provides a comprehensive overview of risk factors for delirium in COVID-19 patients.
  • Identifying these predisposing and precipitating factors is crucial for improving clinical management and treatment strategies for delirium in this population.
  • The findings are expected to significantly impact the care of COVID-19 patients experiencing or at risk for delirium.

Keywords:
COVID-19DeliriumMeta-analysisReviewRisk factors

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