Department of Neurosurgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China.
Department of Cardiovascular Surgery, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
J Neurol. 2023 Oct;270(10):4608-4616. doi: 10.1007/s00415-023-11882-0. Epub 2023 Jul 30.
Delirium is a prevalent symptom of acute brain dysfunction caused by Coronavirus disease 2019 (COVID-19). However, the understanding of delirium in COVID-19 patients is currently limited. This study aimed to investigate the prevalence of delirium and its risk factors in hospitalized COVID-19 patients for early identification and management of delirium.
This cohort study included hospitalized patients with SARS-CoV-2 infection at seven tertiary hospitals from January to February 2023. Delirium was assessed at a single time point using the 3-Minute Diagnostic Assessment for Delirium by trained research assistants. Demographic data, clinical characteristics, in-hospital mortality and other variables were collected from health information system. Multivariate regression analyses were conducted to investigate the risk factors for delirium and the impact of delirium on in-hospital mortality.
A total of 4589 COVID-19 patients were included, out of which 651 cases (14.2%) were identified as delirium. In the multivariable analysis, aging (OR 3.58 [95%CI 2.75-4.67], p < 0.001), higher aspartic transaminase/alanine transaminase ratio (OR = 1.11, [95%CI 1.02-1.21], p = 0.018), Mg (OR = 3.04, [95%CI 2.56-3.62], p < 0.001), blood urea nitrogen (OR = 1.01, [95%CI 1.00, 1.02], p = 0.024), and indwelling urethral catheterization (OR = 1.59, [95%CI 1.21, 2.09], p < 0.001) were associated with an increased risk of delirium. After adjusting for age, sex, and CCI, delirium was found to be associated with an increased risk of in-hospital mortality (OR = 2.42, [95%CI 1.59, 3.67], p < 0.001).
Delirium was a frequent complication among hospitalized COVID-19 patients and was related to unfavorable outcomes. It is crucial to reduce delirium and its long-term effects by addressing the modifiable risk factors.
谵妄是由 2019 年冠状病毒病（COVID-19）引起的急性脑功能障碍的常见症状。然而，目前对 COVID-19 患者谵妄的认识有限。本研究旨在调查住院 COVID-19 患者谵妄的患病率及其危险因素，以便早期识别和管理谵妄。
这项队列研究纳入了 2023 年 1 月至 2 月期间在七家三级医院感染 SARS-CoV-2 的住院患者。由经过培训的研究助理在单个时间点使用 3 分钟谵妄诊断评估量表评估谵妄。从健康信息系统中收集人口统计学数据、临床特征、院内死亡率和其他变量。进行多变量回归分析以调查谵妄的危险因素以及谵妄对院内死亡率的影响。
共纳入 4589 例 COVID-19 患者，其中 651 例（14.2%）被诊断为谵妄。在多变量分析中，年龄较大（OR 3.58 [95%CI 2.75-4.67]，p<0.001）、天门冬氨酸氨基转移酶/丙氨酸氨基转移酶比值较高（OR=1.11 [95%CI 1.02-1.21]，p=0.018）、Mg（OR=3.04 [95%CI 2.56-3.62]，p<0.001）、血尿素氮（OR=1.01 [95%CI 1.00,1.02]，p=0.024）和留置导尿管（OR=1.59 [95%CI 1.21-2.09]，p<0.001）与谵妄风险增加相关。在校正年龄、性别和 CCI 后，发现谵妄与院内死亡率增加相关（OR=2.42 [95%CI 1.59-3.67]，p<0.001）。
谵妄是住院 COVID-19 患者的常见并发症，与不良结局有关。通过解决可改变的危险因素来减少谵妄及其长期影响至关重要。
