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Multicenter Study
. 2021 Aug;33(8):2327-2333.
doi: 10.1007/s40520-021-01899-8. Epub 2021 Jun 26.

Delirium symptoms duration and mortality in SARS-COV2 elderly: results of a multicenter retrospective cohort study

Alessandro Morandi  1   2 , Paola Rebora  3 , Gianluca Isaia  4 , Eleonora Grossi  5 , Bianca Faraci  5 , Simona Gentile  5 , Mario Bo  4   6 , Maria Grazia Valsecchi  3 , Valentina Deiana  7 , Nives Ghezzi  7 , Julia Miksza  7 , Paolo Blangiardo  7 , Giuseppe Bellelli  7   8
Affiliations
Multicenter Study

Delirium symptoms duration and mortality in SARS-COV2 elderly: results of a multicenter retrospective cohort study

Alessandro Morandi et al. Aging Clin Exp Res. 2021 Aug.

Abstract

Background: Since the occurrence of the SARS-COV2 pandemic, there has been an increasing interest in investigating the epidemiology of delirium. Delirium is frequent in SARS-COV2 patients and it is associated with increased mortality; however, no information is available on the association between delirium duration in SARS-COV2 patients and related outcomes.

Aims: The aim of this study is to investigate the association between the duration of delirium symptoms and in-hospital mortality in older patients with SARS-COV2 infection.

Methods: Retrospective cohort study of patients 65 years of age and older with SARS-CoV 2 infection admitted to two acute geriatric wards and one rehabilitation ward. Delirium symptoms duration was assessed retrospectively with a chart-based validated method. In-hospital mortality was ascertained via medical records.

Results: A total of 241 patients were included. The prevalence of delirium on admission was 16%. The median number of days with delirium symptoms was 4 (IQR 2-6.5) vs. 0 (IQR 0-2) in patients with and without delirium on admission. In the multivariable Cox regression model, each day with a delirium symptom in a patient with the same length of stay was associated with a 10% increase in in-hospital mortality (Hazard ratio 1.1, 95% Confidence interval 1.01-1.2; p = 0.03). Other variables associated with increased risk of in-hospital death were age, comorbidity, CPAP, CRP levels and total number of drugs on admission.

Conclusions: The study supports the necessity to establish protocols for the monitoring and management of delirium during emergency conditions to allow an appropriate care for older patients.

Keywords: COVID; Delirium; Delirium symptoms; Elderly; SARS-COV2.

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Conflict of interest statement

Dr. Morandi and Bellelli received Honoraria from Nestlè. The other authors do not report conflict of interests.

Figures

Fig. 1
Fig. 1
Violin plot and box-plot on the distribution of the percentage of days with delirium symptoms on hospital stay by in-hospital discharge status (dead, alive). Colored areas reports the kernel density in alive subjects (gray) and dead (orange). Box represents first and third quartile and the inner line indicates the median; the whiskers are located at the maximum and minimum observation (outside observations indicated with dots are those out of the 1.5 × interquartile range). The figures shows that the majority of alive patients did not show any delirium symptoms during hospital stay, while patients who died had higher percentage of days with delirium symptoms
See this image and copyright information in PMC

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