Kurahara Yu, Matsuda Yoshinobu, Tsuyuguchi Kazunari, Tokoro Akihiro
Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan.
Department of Infectious Diseases, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan.
Intern Med. 2022 Oct 1;61(19):2861-2866. doi: 10.2169/internalmedicine.9013-21. Epub 2022 Feb 26.
Objective The incidence and clinical importance of delirium in coronavirus disease 2019 (COVID-19) have not yet been fully investigated. The present study reported the prevalence of delirium in patients with COVID-19 and identified the factors associated with delirium and mortality. Methods We performed an observational, retrospective study of patients diagnosed with COVID-19 at the Kinki-Chuo Chest Medical Center. Univariate and multivariate logistic regression analyses were used to explore delirium risk factors. Patients All consecutive patients diagnosed with COVID-19 at the Kinki-Chuo Chest Medical Center. Results We identified 600 patients [median age: 61.0 (interquartile range: 49.0-77.0) years old], of whom 61 (10.2%) developed delirium during their stay. Compared with patients without delirium, these patients were older (median age 84.0 vs. 56.0 years old, p<0.01) and had more comorbidities. Based on a multivariate analysis, age, dementia, severe disease, and lactate dehydrogenase (LDH) levels were independent risk factors for developing delirium. For every 1-year increase in age and 10-IU/L increase in LDH, the delirium risk increased by 10.8-12.0% and 4.6-5.7%, respectively. There were 15 (24.6%) in-hospital deaths in the group with delirium and 8 (1.6%) in the group without delirium (p<0.01). Delirium was associated with an increased mortality. Conclusion Delirium in patients with COVID-19 is prevalent and associated with poor clinical outcomes in Japan. Despite difficulties with COVID-19 patient care during the pandemic, physicians should be aware of the risk of delirium and be trained in its optimal management.
目的 2019冠状病毒病（COVID-19）中谵妄的发病率及临床重要性尚未得到充分研究。本研究报告了COVID-19患者中谵妄的患病率，并确定了与谵妄及死亡率相关的因素。方法 我们对近畿中央胸部医疗中心诊断为COVID-19的患者进行了一项观察性回顾性研究。采用单因素和多因素逻辑回归分析来探究谵妄的危险因素。患者 近畿中央胸部医疗中心所有连续诊断为COVID-19的患者。结果 我们纳入了600例患者[中位年龄：61.0（四分位间距：49.0 - 77.0）岁]，其中61例（10.2%）在住院期间发生谵妄。与无谵妄的患者相比，这些患者年龄更大（中位年龄84.0岁对56.0岁，p<0.01）且合并症更多。基于多因素分析，年龄、痴呆、重症疾病及乳酸脱氢酶（LDH）水平是发生谵妄的独立危险因素。年龄每增加1岁及LDH每升高10 IU/L，谵妄风险分别增加10.8 - 12.0%和4.6 - 5.7%。谵妄组有15例（24.6%）住院死亡，无谵妄组有8例（1.6%）（p<0.01）。谵妄与死亡率增加相关。结论 在日本，COVID-19患者中的谵妄很常见且与不良临床结局相关。尽管在疫情期间COVID-19患者护理存在困难，但医生应意识到谵妄风险并接受其最佳管理方面的培训。
