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Delirium occurrence and association with outcomes in hospitalized COVID-19 patients

Published online by Cambridge University Press:  23 September 2021

Sandeep Pagali Open the ORCID record for Sandeep Pagali [Opens in a new window] ,
Sunyang Fu ,
Heidi Lindroth ,
Sunghwan Sohn ,
M. Caroline Burton  and
Maria Lapid
Sandeep Pagali*
Affiliation:
Assistant Professor, Department of Medicine, Division of Hospital Internal Medicine & Division of Geriatric Medicine and Gerontology, Mayo Clinic, Rochester, MN, USA
Sunyang Fu
Affiliation:
Senior Data Science Analyst, Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
Heidi Lindroth
Affiliation:
Nurse Research Scientist, Doctorate in Nursing, Department of Nursing, Division of Nursing Research, Mayo Clinic, Rochester, MN, USA
Sunghwan Sohn
Affiliation:
Associate Professor, Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA
M. Caroline Burton
Affiliation:
Professor, Department of Medicine, Chair-Division of Hospital Internal Medicine, Mayo Clinic, Rochester, MN, USA
Maria Lapid
Affiliation:
Professor, Department of Psychiatry and Psychology & Division of Geriatric Medicine and Gerontology, Mayo Clinic, Rochester, MN, USA
*
Correspondence should be addressed to: Sandeep R Pagali, MD, MPH, Assistant Professor of Medicine, Division of Hospital Medicine, 200 First St SW, Mayo Clinic, Rochester, MN55905, USA. Phone: 507-293-3589; Fax: 507-255-9189. Email: Pagali.sandeep@mayo.edu.
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Abstract

Delirium is reported to be one of the manifestations of coronavirus infectious disease 2019 (COVID-19) infection. COVID-19 hospitalized patients are at a higher risk of delirium. Pathophysiology behind the association of delirium and COVID-19 is uncertain. We analyzed the association of delirium occurrence with outcomes in hospitalized COVID-19 patients, across all age groups, at Mayo Clinic hospitals.

A retrospective study of all hospitalized COVID-19 patients at Mayo Clinic between March 1, 2020 and December 31, 2020 was performed. Occurrence of delirium and outcomes of mortality, length of stay, readmission, and 30-day mortality after hospital discharge were measured. Chi-square test, student t-test, survival analysis, and logistic regression analysis were performed to measure and compare outcomes of delirium group adjusted for age, sex, Charlson comorbidity score, and COVID-19 severity with no-delirium group.

A total of 4351 COVID-19 patients were included in the study. Delirium occurrence in the overall study population was noted to be 22.4%. The highest occurrence of delirium was also noted in patients with critical COVID-19 illness severity. A statistically significant OR 4.35 (3.27–5.83) for in-hospital mortality and an OR 4.54 (3.25–6.38) for 30-day mortality after discharge in the delirium group were noted. Increased hospital length of stay, 30-day readmission, and need for skilled nursing facility on discharge were noted in the delirium group. Delirium in hospitalized COVID-19 patients is a marker for increased mortality and morbidity. In this group, outcomes appear to be much worse when patients are older and have a critical severity of COVID-19 illness.

Keywords

deliriumhospitalized COVID-19outcomesCOVID-19 severity
Type
Brief Report
Information
International Psychogeriatrics , Volume 33 , Special Issue 10: Issue Theme: Non-cognitive Concerns in People with Dementia , October 2021 , pp. 1105 - 1109
Copyright
© International Psychogeriatric Association 2021

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