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Year : 2022  |  Volume : 12  |  Issue : 2  |  Page : 61-69

Intensive care unit delirium in patients with severe COVID-19: A prospective observational cohort study

1 Department of Internal Medicine, Mayo Clinic School of Graduate Medical Education, Mayo Clinic, Rochester, Minnesota, USA
2 Division of Psychiatry, Mayo Clinic Florida; Department of Neurology, Mayo Clinic Florida, Florida, USA
3 Division of Gastroenterology and Hepatology, Mayo Clinic Arizona, Phoenix, Arizona, USA
4 Department of Critical Care Medicine, Mayo Clinic Arizona; Division of Pulmonary Medicine, Mayo Clinic Arizona, Phoenix, Arizona, USA

Correspondence Address:
Dr. Rodrigo Cartin-Ceba
5777 East Mayo Boulevard, Phoenix, Arizona 85054
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijciis.ijciis_93_21

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Background: Delirium is common in patients with severe coronavirus disease-19 (COVID-19). The purpose of our study was to determine whether severe COVID-19 is an independent risk factor for the development of delirium in patients treated in the intensive care unit (ICU). Methods: This prospective observational cohort study involved 162 critically ill patients admitted to a multidisciplinary ICU during 2019 and 2020. A validated screening tool was used to diagnose delirium. Multiple delirium risk factors were collected daily including clinical characteristics, hospital course, lab values, vital signs, surgical exposure, drug exposure, and COVID-19 characteristics. After univariate analysis, a multivariate logistic regression analysis was performed to determine independent risk factors associated with the development of delirium. Results: In our study population, 50 (31%) patients developed delirium. A total of 39 (24.1%) tested positive for COVID-19. Initial analysis showed COVID-19 to be more prevalent in those patients that developed delirium (40% vs. 17%; P = 0.003). Multivariate analysis showed opioid use (odds ratio [OR]: 24 [95% confidence intervals (CI): 16–27]; P ≤ 0.001), benzodiazepine use (OR: 23 [95% CI: 16–63] P = 0.001), and estimated mortality based on acute physiology and chronic health evaluation IV score (OR: 1.04 [95% CI: 1.01–1.07] P = 0.002) to be independently associated with delirium development. COVID-19 (OR: 1.44 [95% CI: 0.13–10.6]; P = 0.7) was not found to be associated with delirium. Conclusion: Delirium is prevalent in critically ill patients admitted to the ICU, including those with COVID-19. However, after adjustment for important covariates, we found in this cohort that COVID-19 was not an independent risk factor for delirium.

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