COVID-19 might cause delirium in acutely ill hospitalized patients, study finds

Delirium, a mental state marked by intense confusion and emotional disruption, may be common in hospitalized COVID-19 patients, according to a study published in The Lancet Psychiatry.

For the study, researchers searched several databases, including Medline, Embase and medRxiv, for studies related to psychiatric and neuropsychiatric conditions of individuals with suspected or confirmed SARS, MERS or the new coronavirus. They included 65 peer-reviewed studies and seven that have not been peer-reviewed. The total number of coronavirus cases in the included studies was 3,559.

Twelve of the studies looked at the new coronavirus specifically and found evidence of delirium. Researchers found evidence of confusion in 26 of 40 intensive care unit patients; agitation in 40 of 58 ICU patients; and altered consciousness in 17 of 82 patients who subsequently died while they were acutely ill with COVID-19.

Six studies that assessed SARS and MERS patients after recovery found frequent reports of low mood, insomnia, anxiety, irritability, memory impairment, fatigue and frequent recall of traumatic memories during a follow-up period ranging from six weeks to a little over three years.

Researchers also estimate that the prevalence of post-traumatic stress disorder among SARS and MERS survivors was 33 percent at an average of about three years after the illness, and rates of depression and anxiety disorders were about 15 percent at an average of two years after the infection.

"While there is little evidence to suggest that common mental illnesses beyond short-term delirium are a feature of COVID-19 infection, clinicians should monitor for the possibility that common mental disorders such as depression, anxiety, fatigue, and PTSD could arise in the weeks and months following recovery from severe infection, as has been seen with SARS and MERS," said Jonathan Rogers, a clinical PhD fellow at the University College London in the U.K., who co-led the study.

More articles on patient safety & outcomes:
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