Dataset Information

Delirium in Patients with SARS-CoV-2 Infection: A Multicenter Study.

ABSTRACT:

Objectives

The aims of this study are to report the prevalence of delirium on admission to the unit in patients hospitalized with SARS-CoV-2 infection, to identify the factors associated with delirium, and to evaluate the association between delirium and in-hospital mortality.

Design

Multicenter observational cohort study.

Settings

Acute medical units in four Italian hospitals.

Participants

A total of 516 patients (median age 78?years) admitted to the participating centers with SARS-CoV-2 infection from February 22 to May 17, 2020.

Measurements

Comprehensive medical assessment with detailed history, physical examinations, functional status, laboratory and imaging procedures. On admission, delirium was determined by the Diagnostic and Statistical Manual of Mental Disorders (5th edition) criteria, 4AT, m-Richmond Agitation Sedation Scale, or clinical impression depending on the site. The primary outcomes were delirium rates and in-hospital mortality.

Results

Overall, 73 (14.1%, 95% confidence interval (CI) = 11.0-17.3%) patients presented delirium on admission. Factors significantly associated with delirium were dementia (odds ratio, OR = 4.66, 95% CI = 2.03-10.69), the number of chronic diseases (OR = 1.20, 95% CI = 1.03; 1.40), and chest X-ray or CT opacity (OR = 3.29, 95% CI = 1.12-9.64 and 3.35, 95% CI = 1.07-10.47, for multiple or bilateral opacities and single opacity vs no opacity, respectively). There were 148 (33.4%) in-hospital deaths in the no-delirium group and 43 (58.9%) in the delirium group (P-value assessed using the Gray test <.001). As assessed by a multivariable Cox model, patients with delirium on admission showed an almost twofold increased hazard ratio for in-hospital mortality with respect to patients without delirium (hazard ratio = 1.88, 95% CI = 1.25-2.83).

Conclusion

Delirium is prevalent and associated with in-hospital mortality among older patients hospitalized with SARS-CoV-2 infection.

SUBMITTER: Rebora P

PROVIDER: S-EPMC7753490 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Delirium in Patients with SARS-CoV-2 Infection: A Multicenter Study.

Rebora Paola P Rozzini Renzo R Bianchetti Angelo A Blangiardo Paolo P Marchegiani Alice A Piazzoli Andrea A Mazzeo Francesca F Cesaroni Giulia G Chizzoli Anita A Guerini Fabio F Bonfanti Paolo P Morandi Alessandro A Faraci Bianca B Gentile Simona S Bna Claudio C Savelli Giordano G Citerio Giuseppe G Valsecchi Maria Grazia MG Mazzola Paolo P Bellelli Giuseppe G

Journal of the American Geriatrics Society 20201208 2

<h4>Objectives</h4>The aims of this study are to report the prevalence of delirium on admission to the unit in patients hospitalized with SARS-CoV-2 infection, to identify the factors associated with delirium, and to evaluate the association between delirium and in-hospital mortality.<h4>Design</h4>Multicenter observational cohort study.<h4>Settings</h4>Acute medical units in four Italian hospitals.<h4>Participants</h4>A total of 516 patients (median age 78 years) admitted to the participating c ...[more]

PMID: 33411332

Similar Datasets

Project description:BackgroundThe impact of corticosteroids on patients with severe coronavirus disease 2019 (COVID-19)/chronic hepatitis B virus (HBV) co-infection is currently unknown. We aimed to investigate the association of corticosteroids on these patients.MethodsThis retrospective multicenter study screened 5447 confirmed COVID-19 patients hospitalized between Jan 1, 2020 to Apr 18, 2020 in seven centers in China, where the prevalence of chronic HBV infection is moderate to high. Severe patients who had chronic HBV and acute SARS-cov-2 infection were potentially eligible. The diagnosis of chronic HBV infection was based on positive testing for hepatitis B surface antigen (HBsAg) or HBV DNA during hospitalization and a medical history of chronic HBV infection. Severe patients (meeting one of following criteria: respiratory rate > 30 breaths/min; severe respiratory distress; or SpO2 ≤ 93% on room air; or oxygen index < 300 mmHg) with COVID-19/HBV co-infection were identified. The bias of confounding variables on corticosteroids effects was minimized using multivariable logistic regression model and inverse probability of treatment weighting (IPTW) based on propensity score.ResultsThe prevalence of HBV co-infection in COVID-19 patients was 4.1%. There were 105 patients with severe COVID-19/HBV co-infections (median age 62 years, 57.1% male). Fifty-five patients received corticosteroid treatment and 50 patients did not. In the multivariable analysis, corticosteroid therapy (OR, 6.32, 95% CI 1.17-34.24, P = 0.033) was identified as an independent risk factor for 28-day mortality. With IPTW analysis, corticosteroid treatment was associated with delayed SARS-CoV-2 viral RNA clearance (OR, 2.95, 95% CI 1.63-5.32, P < 0.001), increased risk of 28-day and in-hospital mortality (OR, 4.90, 95% CI 1.68-14.28, P = 0.004; OR, 5.64, 95% CI 1.95-16.30, P = 0.001, respectively), and acute liver injury (OR, 4.50, 95% CI 2.57-7.85, P < 0.001). Methylprednisolone dose per day and cumulative dose in non-survivors were significantly higher than in survivors.ConclusionsIn patients with severe COVID-19/HBV co-infection, corticosteroid treatment may be associated with increased risk of 28-day and in-hospital mortality.

Dataset Information

Delirium in Patients with SARS-CoV-2 Infection: A Multicenter Study.

Objectives

Design

Settings

Participants

Measurements

Results

Conclusion

Publications

Delirium in Patients with SARS-CoV-2 Infection: A Multicenter Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets