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Delirium in Critically Ill Patients with and without COVID-19—A Retrospective Analysis

Background: Delirium complicating the course of Intensive care unit (ICU) therapy is a known driver of morbidity and mortality. It has been speculated that infection with the neurotrophic SARS-CoV-2 might promote delirium. Methods: Retrospective registry analysis including all patients treated at le...

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Autores principales: Jäckel, Markus, Aicher, Nico, Biever, Paul Marc, Heine, Laura, Bemtgen, Xavier, Rilinger, Jonathan, Zotzmann, Viviane, Supady, Alexander, Stachon, Peter, Wengenmayer, Tobias, Bode, Christoph, Staudacher, Dawid Leander
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509381/
https://www.ncbi.nlm.nih.gov/pubmed/34640428
http://dx.doi.org/10.3390/jcm10194412
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author Jäckel, Markus
Aicher, Nico
Biever, Paul Marc
Heine, Laura
Bemtgen, Xavier
Rilinger, Jonathan
Zotzmann, Viviane
Supady, Alexander
Stachon, Peter
Wengenmayer, Tobias
Bode, Christoph
Staudacher, Dawid Leander
author_facet Jäckel, Markus
Aicher, Nico
Biever, Paul Marc
Heine, Laura
Bemtgen, Xavier
Rilinger, Jonathan
Zotzmann, Viviane
Supady, Alexander
Stachon, Peter
Wengenmayer, Tobias
Bode, Christoph
Staudacher, Dawid Leander
author_sort Jäckel, Markus
collection PubMed
description Background: Delirium complicating the course of Intensive care unit (ICU) therapy is a known driver of morbidity and mortality. It has been speculated that infection with the neurotrophic SARS-CoV-2 might promote delirium. Methods: Retrospective registry analysis including all patients treated at least 48 h on a medical intensive care unit. The primary endpoint was development of delirium as diagnosed by Nursing Delirium screening scale ≥2. Results were confirmed by propensity score matching. Results: 542 patients were included. The primary endpoint was reached in 352/542 (64.9%) patients, without significant differences between COVID-19 patients and non-COVID-19 patients (51.4% and 65.9%, respectively, p = 0.07) and correlated with prolonged ICU stay in both groups. In a subgroup of patients with ICU stay >10 days delirium was significantly lower in COVID-19 patients (p ≤ 0.01). After adjustment for confounders, COVID-19 correlated independently with less ICU delirium (p ≤ 0.01). In the propensity score matched cohort, patients with COVID-19 had significantly lower delirium incidence compared to the matched control patients (p ≤ 0.01). Conclusion: Delirium is frequent in critically ill patients with and without COVID-19 treated at an intensive care unit. Data suggests that COVID-19 itself is not a driver of delirium per se.
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spelling pubmed-85093812021-10-13 Delirium in Critically Ill Patients with and without COVID-19—A Retrospective Analysis Jäckel, Markus Aicher, Nico Biever, Paul Marc Heine, Laura Bemtgen, Xavier Rilinger, Jonathan Zotzmann, Viviane Supady, Alexander Stachon, Peter Wengenmayer, Tobias Bode, Christoph Staudacher, Dawid Leander J Clin Med Article Background: Delirium complicating the course of Intensive care unit (ICU) therapy is a known driver of morbidity and mortality. It has been speculated that infection with the neurotrophic SARS-CoV-2 might promote delirium. Methods: Retrospective registry analysis including all patients treated at least 48 h on a medical intensive care unit. The primary endpoint was development of delirium as diagnosed by Nursing Delirium screening scale ≥2. Results were confirmed by propensity score matching. Results: 542 patients were included. The primary endpoint was reached in 352/542 (64.9%) patients, without significant differences between COVID-19 patients and non-COVID-19 patients (51.4% and 65.9%, respectively, p = 0.07) and correlated with prolonged ICU stay in both groups. In a subgroup of patients with ICU stay >10 days delirium was significantly lower in COVID-19 patients (p ≤ 0.01). After adjustment for confounders, COVID-19 correlated independently with less ICU delirium (p ≤ 0.01). In the propensity score matched cohort, patients with COVID-19 had significantly lower delirium incidence compared to the matched control patients (p ≤ 0.01). Conclusion: Delirium is frequent in critically ill patients with and without COVID-19 treated at an intensive care unit. Data suggests that COVID-19 itself is not a driver of delirium per se. MDPI 2021-09-26 /pmc/articles/PMC8509381/ /pubmed/34640428 http://dx.doi.org/10.3390/jcm10194412 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Jäckel, Markus
Aicher, Nico
Biever, Paul Marc
Heine, Laura
Bemtgen, Xavier
Rilinger, Jonathan
Zotzmann, Viviane
Supady, Alexander
Stachon, Peter
Wengenmayer, Tobias
Bode, Christoph
Staudacher, Dawid Leander
Delirium in Critically Ill Patients with and without COVID-19—A Retrospective Analysis
title Delirium in Critically Ill Patients with and without COVID-19—A Retrospective Analysis
title_full Delirium in Critically Ill Patients with and without COVID-19—A Retrospective Analysis
title_fullStr Delirium in Critically Ill Patients with and without COVID-19—A Retrospective Analysis
title_full_unstemmed Delirium in Critically Ill Patients with and without COVID-19—A Retrospective Analysis
title_short Delirium in Critically Ill Patients with and without COVID-19—A Retrospective Analysis
title_sort delirium in critically ill patients with and without covid-19—a retrospective analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8509381/
https://www.ncbi.nlm.nih.gov/pubmed/34640428
http://dx.doi.org/10.3390/jcm10194412
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