COVID-19 患者谵妄的患病率、发病率和死亡率：系统评价和荟萃分析。

Prevalence, incidence and mortality of delirium in patients with COVID-19: a systematic review and meta-analysis.

机构信息

Department of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.

School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

出版信息

Age Ageing. 2021 Sep 11;50(5):1445-1453. doi: 10.1093/ageing/afab103.

DOI:10.1093/ageing/afab103

PMID:33984129

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8247209/

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.

摘要

背景

由于高龄会增加谵妄和与 COVID-19 相关死亡的风险，因此应注意 2019 年冠状病毒病（COVID-19）患者的谵妄。

目的

本研究旨在总结 COVID-19 患者谵妄的患病率、发病率和死亡率的证据。

方法

我们对 Pubmed 和 Embase 从创建到 2020 年 12 月 1 日进行了全面的文献检索。三名独立的评审员评估了研究的合格性和数据提取，并评估了研究质量。使用 95%置信区间（CI）计算了结果的比例。我们还使用优势比比较了 COVID-19 患者的死亡率差异。

结果

总共从 13 个国家的 48 项研究中确定了 11553 例 COVID-19 患者。COVID-19 患者谵妄的合并患病率、发病率和死亡率分别为 24.3%（95%CI：19.4-29.6%）、32.4%（95%CI：20.8-45.2%）和 44.5%（95%CI：36.1-53.0%）。对于年龄在 65 岁以上的患者，COVID-19 患者谵妄的患病率、发病率和死亡率分别为 28.2%（95%CI：23.5-33.1%）、25.2%（95%CI：16.0-35.6%）和 48.4%（95%CI：40.6-56.1%）。对于年龄在 65 岁以下的患者，COVID-19 患者谵妄的患病率、发病率和死亡率分别为 15.7%（95%CI：9.2-23.6%）、71.4%（95%CI：58.5-82.7%）和 21.2%（95%CI：15.4-27.6%）。总体而言，与没有谵妄的 COVID-19 患者相比，患有谵妄的 COVID-19 患者的死亡率风险更高（OR：3.2，95%CI：2.1-4.8）。