Delirium and adverse outcomes in hospitalized patients with COVID‐19.

In this longitudinal observational study. recently published in the Journal of the American Geriatrics Society, the authors investigate the occurrence of delirium in hospitalised patients with COVID‐19 and explore its association with adverse outcomes. 707 COVID-19 patients aged ≥50 years consecutively admitted to a tertiary university hospital dedicated to the care of severe cases of COVID‐19 in Sao Paulo, Brazil, between March and May 2020 were included. Delirium occurrence were detected using the Chart‐based Delirium Identification Instrument (CHART‐DEL). The outcomes of interest were in‐hospital death, length of stay, admission to intensive care, and ventilator utilisation. All multivariable analyses were adjusted for age, sex, clinical history, vital signs, and relevant laboratory biomarkers (lymphocyte count, C‐reactive protein, glomerular filtration rate, D‐dimer, albumin). Overall, the authors identified delirium in 234 participants (33%). On admission, 86 (12%) were delirious. 263 deaths (37%) were observed, and in‐hospital mortality reached 55% in patients who experienced delirium. Delirium was associated with in‐hospital death, with an adjusted odds ratio [aOR] of 1.75 (95% confidence interval [95%CI]= 1.15‐2.66); the association held both in middle‐aged and older adults. Delirium was also associated with increased length of stay, admission to intensive care, and ventilator utilisation. The authors concluded that delirium was independently associated with in‐hospital death in adults aged ≥50 years with COVID‐19 and that, despite the difficulties for patient care during the pandemic, clinicians should routinely monitor delirium when assessing severity and prognosis of COVID‐19 patients.

https://doi.org/10.1111/jgs.16803

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