Shih-Chieh Shao1,2, Chien-Cheng Lai3, Yi-Hung Chen1, Yung-Chang Chen4,5, Ming-Jui Hung5,6, Shu-Chen Liao5,7. 1. Department of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan. 2. School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan. 3. Department of Traditional Chinese Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan. 4. Department of Nephrology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan. 5. College of Medicine, Chang Gung University, Taoyuan, Taiwan. 6. Section of Cardiology, Department of Internal Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan. 7. Department of Emergency Medicine, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.
Abstract
BACKGROUND: Attention should be paid to delirium in coronavirus disease 2019 (COVID-19) patients, especially older people, since advanced age poses increased risk of both delirium and COVID-19-related death. OBJECTIVE: This study aims to summarise the evidence on prevalence, incidence and mortality of delirium in COVID-19 patients. METHODS: We conducted a comprehensive literature search on Pubmed and Embase from inception to 1 December 2020. Three independent reviewers evaluated study eligibility and data extraction, and assessed study quality. Outcomes were analysed as proportions with 95% confidence interval (CI). We also compared mortality differences in COVID-19 patients using odds ratio. RESULTS: In total, we identified 48 studies with 11,553 COVID-19 patients from 13 countries. Pooled prevalence, incidence and mortality rates for delirium in COVID-19 patients were 24.3% (95% CI: 19.4-29.6%), 32.4% (95% CI: 20.8-45.2%) and 44.5% (95% CI: 36.1-53.0%), respectively. For patients aged over 65 years, prevalence, incidence and mortality rates for delirium in COVID-19 patients were 28.2% (95% CI: 23.5-33.1%), 25.2% (95% CI: 16.0-35.6%) and 48.4% (95% CI: 40.6-56.1%), respectively. For patients under 65 years, prevalence, incidence and mortality rates for delirium in COVID-19 patients were 15.7% (95% CI: 9.2-23.6%), 71.4% (95% CI: 58.5-82.7%) and 21.2% (95% CI: 15.4-27.6%), respectively. Overall, COVID-19 patients with delirium suffered higher risk of mortality, compared with those without delirium (OR: 3.2, 95% CI: 2.1-4.8). CONCLUSION: Delirium developed in almost 1 out of 3 COVID-19 patients, and was associated with 3-fold overall mortality. Our findings suggest that first-line healthcare providers should systematically assess delirium and monitor related symptoms among COVID-19 patients.
BACKGROUND: Attention should be paid to delirium in coronavirus disease 2019 (COVID-19) patients, especially older people, since advanced age poses increased risk of both delirium and COVID-19-related death. OBJECTIVE: This study aims to summarise the evidence on prevalence, incidence and mortality of delirium in COVID-19 patients. METHODS: We conducted a comprehensive literature search on Pubmed and Embase from inception to 1 December 2020. Three independent reviewers evaluated study eligibility and data extraction, and assessed study quality. Outcomes were analysed as proportions with 95% confidence interval (CI). We also compared mortality differences in COVID-19 patients using odds ratio. RESULTS: In total, we identified 48 studies with 11,553 COVID-19 patients from 13 countries. Pooled prevalence, incidence and mortality rates for delirium in COVID-19 patients were 24.3% (95% CI: 19.4-29.6%), 32.4% (95% CI: 20.8-45.2%) and 44.5% (95% CI: 36.1-53.0%), respectively. For patients aged over 65 years, prevalence, incidence and mortality rates for delirium in COVID-19 patients were 28.2% (95% CI: 23.5-33.1%), 25.2% (95% CI: 16.0-35.6%) and 48.4% (95% CI: 40.6-56.1%), respectively. For patients under 65 years, prevalence, incidence and mortality rates for delirium in COVID-19 patients were 15.7% (95% CI: 9.2-23.6%), 71.4% (95% CI: 58.5-82.7%) and 21.2% (95% CI: 15.4-27.6%), respectively. Overall, COVID-19 patients with delirium suffered higher risk of mortality, compared with those without delirium (OR: 3.2, 95% CI: 2.1-4.8). CONCLUSION: Delirium developed in almost 1 out of 3 COVID-19 patients, and was associated with 3-fold overall mortality. Our findings suggest that first-line healthcare providers should systematically assess delirium and monitor related symptoms among COVID-19 patients.
Authors: Annabella Di Giorgio; Antonio Mirijello; Clara De Gennaro; Andrea Fontana; Paolo Emilio Alboini; Lucia Florio; Vincenzo Inchingolo; Michele Zarrelli; Giuseppe Miscio; Pamela Raggi; Carmen Marciano; Annibale Antonioni; Salvatore De Cosmo; Filippo Aucella; Antonio Greco; Massimo Carella; Massimiliano Copetti; Maurizio A Leone Journal: Diagnostics (Basel) Date: 2022-02-20
Authors: Sara C LaHue; Danielle P Escueta; Elan L Guterman; Kanan Patel; Krista L Harrison; W John Boscardin; Vanja C Douglas; John C Newman Journal: BMC Psychiatry Date: 2022-02-28 Impact factor: 3.630