Aman Saini1, Tae Hyun Oh2, Dory Anthony Ghanem1, Megan Castro3, Matthew Butler3, Chun Chiang Sin Fai Lam4, Sotiris Posporelis3,4, Glyn Lewis5, Anthony S David6, Jonathan P Rogers4,5. 1. Medical School, University College London, London, UK. 2. Department of Psychological Medicine, King's College London, London, UK. 3. Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. 4. South London and Maudsley NHS Foundation Trust, London, UK. 5. Division of Psychiatry, University College London, London, UK. 6. Institute of Mental Health, University College London, London, UK.
Abstract
OBJECTIVES: We aimed to find the association of inflammation and respiratory failure with delirium in COVID-19 patients. We compare the inflammatory and arterial blood gas markers between patients with COVID-19 delirium and delirium in other medical disorders. METHODS: This cross-sectional study used the CHART-DEL, a validated research tool, to screen patients for delirium retrospectively from clinical notes. Inflammatory markers C-reactive protein (CRP) and white cell count (WBC), and the partial pressures of oxygen (PO2) and carbon dioxide (PCO2) were compared between patients with COVID-19 delirium and delirium in other medical disorders. RESULTS: In bivariate analysis, CRP (mg/L) was significantly higher in the COVID-19 group, (81.7 ± 80.0 vs. 58.8 ± 87.7, p = 0.04), and WBC (109/L) was significantly lower (7.44 ± 3.42 vs. 9.71 ± 5.45, p = 0.04). The geometric mean of CRP in the COVID-19 group was 140% higher in multiple linear regression (95% CI = 7-439%, p = 0.03) with age and sex as covariates. There were no significant differences in pO2 or pCO2 across groups. CONCLUSION: The association between higher CRP and COVID-19 in patients with delirium may suggest an inflammatory basis for delirium in COVID-19. Our findings may assist clinicians in establishing whether delirium is due to COVID-19, which may improve management and outcomes of infected patients.
OBJECTIVES: We aimed to find the association of inflammation and respiratory failure with delirium in COVID-19 patients. We compare the inflammatory and arterial blood gas markers between patients with COVID-19 delirium and delirium in other medical disorders. METHODS: This cross-sectional study used the CHART-DEL, a validated research tool, to screen patients for delirium retrospectively from clinical notes. Inflammatory markers C-reactive protein (CRP) and white cell count (WBC), and the partial pressures of oxygen (PO2) and carbon dioxide (PCO2) were compared between patients with COVID-19 delirium and delirium in other medical disorders. RESULTS: In bivariate analysis, CRP (mg/L) was significantly higher in the COVID-19 group, (81.7 ± 80.0 vs. 58.8 ± 87.7, p = 0.04), and WBC (109/L) was significantly lower (7.44 ± 3.42 vs. 9.71 ± 5.45, p = 0.04). The geometric mean of CRP in the COVID-19 group was 140% higher in multiple linear regression (95% CI = 7-439%, p = 0.03) with age and sex as covariates. There were no significant differences in pO2 or pCO2 across groups. CONCLUSION: The association between higher CRP and COVID-19 in patients with delirium may suggest an inflammatory basis for delirium in COVID-19. Our findings may assist clinicians in establishing whether delirium is due to COVID-19, which may improve management and outcomes of infected 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