Delirium is a Good Predictor for Poor Outcomes from Coronavirus Disease 2019 (COVID-19) Pneumonia: A Systematic Review, Meta-analysis, and Meta-regression

Overview

Journal J Psychiatr Res

Specialty Psychiatry

Date 2021 Aug 23

PMID 34425488

Citations 22

Authors

Timotius Ivan Hariyanto

Cynthia Putri

Joshua Edward Hananto

Jessie Arisa

Rocksy Fransisca V Situmeang

Andree Kurniawan

Affiliations

Soon will be listed here.

Abstract

Aim: Delirium is a common presenting symptom among older patients. Patients who presented with delirium may have a higher morbidity and mortality rate due to older age, other comorbidities, and atypical COVID-19 presentation. Currently, the evidence supporting delirium as one of the predictors of poor outcome of COVID-19 is still insufficient. This study aims to explore the potential association between delirium and poor outcomes from COVID-19.

Methods: We systematically searched the PubMed and Google Scholar databases using specific keywords related to our aims until January 30th, 2021. All articles published on COVID-19 and delirium were retrieved. The quality of the study was assessed using the Newcastle Ottawa Scale (NOS) tool for observational studies and Joanna Briggs Institute (JBI) Critical Appraisal Tools for case-series studies. Statistical analysis was done using Review Manager 5.4 software.

Results: Our meta-analysis of 20 studies showed that delirium symptoms on admission was associated with poor outcomes from COVID-19 [OR 2.36 (95% CI 1.80-3.09), p < 0.00001, I = 76%, random-effect models] and its subgroup which consist of severe COVID-19 [OR 3.89 (95% CI 1.72-8.75), p = 0.001, I = 91%, random-effect models], and mortality from COVID-19 [OR 1.90 (95% CI 1.55-2.33), p < 0.00001, I = 36%, random-effect models]. Meta-regression showed that the association was influenced by age (p = 0.005).

Conclusions: Our study suggests delirium as an important marker to identify patients at higher risk for developing poor COVID-19 outcomes. The physicians should add delirium as one of the common presenting symptoms of COVID-19 in older populations.

Citing Articles

Associations Between COVID-19, Delirium, and 1-Year Mortality: Exploring Influences on Delirium Incidence in COVID-19 Patients.

Jang Y, Hur H, Myung W, Park E, Park H J Korean Med Sci. 2024; 39(32):e232.

PMID: 39164056 PMC: 11333801. DOI: 10.3346/jkms.2024.39.e232.

Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms.

Citarella B, Kartsonaki C, Ibanez-Prada E, Goncalves B, Baruch J, Escher M Heliyon. 2024; 10(10):e29591.

PMID: 38779000 PMC: 11109728. DOI: 10.1016/j.heliyon.2024.e29591.

Delirium in patients with COVID-19 treated in the intensive care unit.

Lee J, Han W, Chun J, Choi Y, Han M, Kim J PLoS One. 2023; 18(11):e0289662.

PMID: 37956150 PMC: 10642827. DOI: 10.1371/journal.pone.0289662.

Risk Factors and Outcomes Associated With Re-Intubation Secondary to Respiratory Failure in Patients With COVID-19 ARDS.

Halaseh R, Drescher G, Al-Ahmad M, Masri I, Alayon A, Ghawanmeh M Respir Care. 2023; 69(1):50-60.

PMID: 37438052 PMC: 10753619. DOI: 10.4187/respcare.10881.

Neurological manifestations of COVID-19 in pregnancy: a cross-sectional study.

Magalhaes J, Sampaio Rocha-Filho P J Neurovirol. 2023; 29(4):472-478.

PMID: 37306922 DOI: 10.1007/s13365-023-01150-2.

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