Clinical presentations and prognosis of delirium in patients with coronavirus disease 2019: A prospective cohort analysis

Abstract

Background: The pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has emerged as one of the biggest health threats of our generation. Since its outbreak, COVID-19 has been showing many typical and some atypical manifestations. One of the common complications in COVID-19 is delirium. Delirium should be detected at the earliest to reduce mortality in COVID-19. Methods: We prospectively studied hospitalized adult (age ≥ 18 years) patients with confirmed COVID-19 from May 1 to May 31, 2021, at GMERS Medical College and Civil Hospital, Sola, Ahmedabad, India. We included all patients suffering from COVID-19 and diagnosed with delirium in the study. Delirium was assessed using the Confusion Assessment Method and Richmond Agitation Sedation Scale. Follow-up was done for delirium patients on days 0, 5, 10, and 30. Results: We included 1,233 patients in the analysis. The incidence of delirium was found 2.43% in which 63.3% were hypoactive delirium while 36.7% were hypoactive delirium presentation. The mean age ± standard deviation of delirium patients was 68.33 ± 14.67 years (range = 46-92) years, and 20 (66.7%) were male and 10 (33.3%) were female. The result of the study also showed statistical significance between deaths in patients of confirmed cases of COVID-19 with delirium (93.33%) than patients of confirmed cases of COVID-19 without delirium (12.38%, p < 0.001). Conclusion: The presence of delirium was associated with increased risk of mortality in hospitalized adults with COVID-19.

Keywords

• confusion assessment method score
• mortality
• richmond agitation sedation scale
• systemic diseases