- A new study finds that COVID-19 patients requiring intensive care are more likely to have delirium and other neurological symptoms
- University of Michigan researchers identify delirium in 73% of patients admitted to Michigan Medicine ICU in spring 2020
- Delirium is a confused mental condition in which patients have limited ability to navigate their environment
- Patients had delirium for at least four days and some for up to 17 days
- Some patients also reported delirium, dementia, depression, and other cognitive issues months after returning home from the hospital.
- Scientists are still working to understand how COVID causes delirium, but it may be linked to inflammation in the brain
A new study finds that COVID-19 patients requiring intensive care are more likely to have delirium and other neurological symptoms.
Researchers at the University of Michigan identified delirium in 73 percent of patients admitted to the Michigan Medicine Intensive Care Unit (ICU) between March 2020 and May 2020.
Patients had the condition for at least four days, with some experiencing symptoms for up to 17 days.
Some patients also reported delirium, dementia, depression, and other cognitive issues in the months after returning home from the hospital.
The findings add additional evidence to previous studies and the experiences of long-term COVID patients, which say neurological issues are a common – as yet studied – aspect of the disease.
A recent study suggests that COVID patients hospitalized in ICU are more likely to have delirium and other neurological symptoms. Image: Nurses care for a COVID patient in an ICU at Sharp Grossmont Hospital in La Mesa, California, May 2020
Covid is commonly seen as a respiratory disease, but in the past year and a half, researchers have listed its potential Affects many other parts of the body.
The disease can cause long-term loss of smell and taste, cardiovascular issues, gastrointestinal complications, neurological symptoms, autoimmune issues, and more.
Neurological symptoms may be one of the most concerning categories.
Prolonged fatigue, ‘brain fog’ and other associated challenges have been documented for long-term Covid patients, who suffer symptoms for weeks or months after their initial infection.
And among hospitalized patients with severe COVID cases, doctors have found that delirium can be a common symptom.
Delirium is a confused mental state, in which patients have limited ability to navigate their environment.
A recent study further demonstrates that delirium is common in patients who require intensive care in hospital.
Physicians at Michigan Medicine, a hospital at the University of Michigan, followed COVID patients who were admitted to the intensive care unit (ICU) with dementia at the start of the pandemic.
his study was published on 17 September In BMJ Open Journal.
In all, Michigan Medicine saw 148 COVID patients in its ICU between March 1 and May 31, 2020.
Of those 148 patients, 108 experienced delirium during their ICU stay.
This accounts for 73 percent – about three-quarters – of all ICU patients.
These patients experienced delirium for at least four days – some as long as 17 days – and the average symptom duration was 10 days.
Half of the patients who experienced delirium were black, following a trend – the majority of ICU patients in hospital were black.
Scientists are still working to understand how COVID causes delirium, but it may be linked to inflammation in the brain – shown here in a brain scan of patient D
The researchers noted, however, that this number of black patients was ‘disproportionately high’ compared to the overall demographics in the hospital.
“Covid is also associated with a number of other adverse outcomes that make hospitalization and recovery difficult,” study author Dr Philip Vliside said in a statement.
Patients with delirium also have other concomitant diseases such as hypertension and diabetes.
In another indication that delirium was associated with more severe covid disease, patients with delirium had longer hospital stays – and longer ICU stays – than patients who did not experience symptoms.
Upon leaving the hospital, about a third of delirium patients had not recovered from the symptom.
Many patients – 40 percent – required assistance from a skilled nurse after leaving the hospital.
As well as recording patients’ experiences with delirium in the hospital, the researchers also surveyed them after they returned home from the hospital.
Two to three months after returning home, the researchers were able to survey about 20 patients and their families.
About a quarter of those patients still had symptoms of delirium two to three months later.
Some patients with delirium also reported dementia, depression, and other cognitive issues that did not resolve months after returning home from the hospital.
Vlisides said, “A family member who is confused has a limited ability to care for themselves and will need additional caregiver support, which is certainly a major challenge.”
Scientists have yet to determine how a coronavirus infection can cause delirium, but researchers at Michigan Medicine say several factors may play a role.
The coronavirus can infect cells of the nervous system, and can also cause an inflammatory response that causes the immune system to attack itself.
Researchers performed brain scans for some patients – and noted that some patients with delirium had signs of abnormal fluid or swelling in the brain.
Michigan Medicine’s findings aligned with other research on delirium in COVID patients, showing that 65 to 80 percent of ICU patients may have this symptom.
However, Vlisides noted that the study’s deadline – during the first wave of the pandemic – could make it possible that some patients experienced delirium because of their hospital stay conditions, not thanks to the virus.
‘From the beginning…