Delirium Incidence, Duration, and Severity in Critically Ill Patients With Coronavirus Disease 2019

dc.contributor.authorKhan, Sikandar H.
dc.contributor.authorLindroth, Heidi
dc.contributor.authorPerkins, Anthony J.
dc.contributor.authorJamil, Yasser
dc.contributor.authorWang, Sophia
dc.contributor.authorRoberts, Scott
dc.contributor.authorFarber, Mark
dc.contributor.authorRahman, Omar
dc.contributor.authorGao, Sujuan
dc.contributor.authorMarcantonio, Edward R.
dc.contributor.authorBoustani, Malaz
dc.contributor.authorMachado, Roberto
dc.contributor.authorKhan, Babar A.
dc.contributor.departmentMedicine, School of Medicineen_US
dc.date.accessioned2022-01-20T18:54:59Z
dc.date.available2022-01-20T18:54:59Z
dc.date.issued2020-12
dc.description.abstractObjectives: To determine delirium occurrence rate, duration, and severity in patients admitted to the ICU with coronavirus disease 2019. Design: Retrospective data extraction study from March 1, 2020, to June 7, 2020. Delirium outcomes were assessed for up to the first 14 days in ICU. Setting: Two large, academic centers serving the state of Indiana. Patients: Consecutive patients admitted to the ICU with positive severe acute respiratory syndrome coronavirus 2 nasopharyngeal swab polymerase chain reaction test from March 1, 2020, to June 7, 2020, were included. Individuals younger than 18 years of age, without any delirium assessments, or without discharge disposition were excluded. Measurements and Main Results: Primary outcomes were delirium rates and duration, and the secondary outcome was delirium severity. Two-hundred sixty-eight consecutive patients were included in the analysis with a mean age of 58.4 years (sd, 15.6 yr), 40.3% were female, 44.4% African American, 20.7% Hispanic, and a median Acute Physiology and Chronic Health Evaluation II score of 18 (interquartile range, 13–25). Delirium without coma occurred in 29.1% of patients, delirium prior to coma in 27.9%, and delirium after coma in 23.1%. The first Confusion Assessment Method for the ICU assessment was positive for delirium in 61.9%. Hypoactive delirium was the most common subtype (87.4%). By day 14, the median number of delirium/coma-free were 5 days (interquartile range, 4–11 d), and median Confusion Assessment Method for the ICU-7 score was 6.5 (interquartile range, 5–7) indicating severe delirium. Benzodiazepines were ordered for 78.4% of patients in the cohort. Mechanical ventilation was associated with greater odds of developing delirium (odds ratio, 5.0; 95% CI, 1.1–22.2; p = 0.033) even after adjusting for sedative medications. There were no between-group differences in mortality. Conclusions: Delirium without coma occurred in 29.1% of patients admitted to the ICU. Delirium persisted for a median of 5 days and was severe. Mechanical ventilation was significantly associated with odds of delirium even after adjustment for sedatives. Clinical attention to manage delirium duration and severity, and deeper understanding of the virus’ neurologic effects is needed for patients with coronavirus disease 2019.en_US
dc.eprint.versionFinal published versionen_US
dc.identifier.citationKhan, S. H., Lindroth, H., Perkins, A. J., Jamil, Y., Wang, S., Roberts, S., Farber, M., Rahman, O., Gao, S., Marcantonio, E. R., Boustani, M., Machado, R., & Khan, B. A. (2020). Delirium Incidence, Duration, and Severity in Critically Ill Patients With Coronavirus Disease 2019. Critical Care Explorations, 2(12), e0290. https://doi.org/10.1097/CCE.0000000000000290en_US
dc.identifier.issn2639-8028en_US
dc.identifier.urihttps://hdl.handle.net/1805/27509
dc.language.isoenen_US
dc.publisherWolters Kluweren_US
dc.relation.isversionof10.1097/CCE.0000000000000290en_US
dc.relation.journalCritical Care Explorationsen_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.sourcePMCen_US
dc.subjectbrain diseasesen_US
dc.subjectcomaen_US
dc.subjectcoronavirus disease 2019en_US
dc.subjectcritical illnessen_US
dc.subjectdeliriumen_US
dc.subjectrespiratory insufficiencyen_US
dc.titleDelirium Incidence, Duration, and Severity in Critically Ill Patients With Coronavirus Disease 2019en_US
dc.typeArticleen_US
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