ICU Delirium Is Associated with Cardiovascular Burden and Higher Mortality in Patients with Severe COVID-19 Pneumonia
Background: COVID-19 can lead to functional disorders and complications, e.g., pulmonary, thromboembolic, and neurological. The neuro-invasive potential of SARS-CoV-2 may result in acute brain malfunction, which manifests as delirium as a symptom. Delirium is a risk factor for death among patients h...
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| Format: | Article |
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MDPI AG
2023-07-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/15/5049 |
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| author | Mateusz Gutowski Jakub Klimkiewicz Andrzej Michałowski Michal Ordak Marcin Możański Arkadiusz Lubas |
| author_facet | Mateusz Gutowski Jakub Klimkiewicz Andrzej Michałowski Michal Ordak Marcin Możański Arkadiusz Lubas |
| author_sort | Mateusz Gutowski |
| collection | DOAJ |
| description | Background: COVID-19 can lead to functional disorders and complications, e.g., pulmonary, thromboembolic, and neurological. The neuro-invasive potential of SARS-CoV-2 may result in acute brain malfunction, which manifests as delirium as a symptom. Delirium is a risk factor for death among patients hospitalized due to critical illness. Taking the above into consideration, the authors investigated risk factors for delirium in COVID-19 patients and its influence on outcomes. Methods: A total of 335 patients hospitalized due to severe forms of COVID-19 were enrolled in the study. Data were collected from medical charts. Results: Delirium occurred among 21.5% of patients. In the delirium group, mortality was significantly higher compared to non-delirium patients (59.7% vs. 28.5%; <i>p</i> < 0.001). Delirium increased the risk of death, with an OR of 3.71 (95% CI 2.16–6.89; <i>p</i> < 0.001). Age, chronic atrial fibrillation, elevated INR, urea, and procalcitonin, as well as decreased phosphates, appeared to be the independent risk factors for delirium occurrence. Conclusions: Delirium occurrence in patients with severe COVID-19 significantly increases the risk of death and is associated with a cardiovascular burden. Hypophosphatemia is a promising reversible factor to reduce mortality in this group of patients. However, larger studies are essential in this area. |
| first_indexed | 2024-03-11T00:24:36Z |
| format | Article |
| id | doaj.art-9f885045657a4de9aa1ecbdfbebd7c35 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T00:24:36Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-9f885045657a4de9aa1ecbdfbebd7c352023-11-18T23:08:43ZengMDPI AGJournal of Clinical Medicine2077-03832023-07-011215504910.3390/jcm12155049ICU Delirium Is Associated with Cardiovascular Burden and Higher Mortality in Patients with Severe COVID-19 PneumoniaMateusz Gutowski0Jakub Klimkiewicz1Andrzej Michałowski2Michal Ordak3Marcin Możański4Arkadiusz Lubas5Department of Anesthesiology and Intensive Care, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, PolandDepartment of Anesthesiology and Intensive Care, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, PolandDepartment of Anesthesiology and Intensive Care, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, PolandDepartment of Pharmacotherapy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, 02-097 Warsaw, PolandDepartment of Anesthesiology and Intensive Care, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, PolandDepartment of Internal Diseases Nephrology and Dialysis, Military Institute of Medicine—National Research Institute, 04-141 Warsaw, PolandBackground: COVID-19 can lead to functional disorders and complications, e.g., pulmonary, thromboembolic, and neurological. The neuro-invasive potential of SARS-CoV-2 may result in acute brain malfunction, which manifests as delirium as a symptom. Delirium is a risk factor for death among patients hospitalized due to critical illness. Taking the above into consideration, the authors investigated risk factors for delirium in COVID-19 patients and its influence on outcomes. Methods: A total of 335 patients hospitalized due to severe forms of COVID-19 were enrolled in the study. Data were collected from medical charts. Results: Delirium occurred among 21.5% of patients. In the delirium group, mortality was significantly higher compared to non-delirium patients (59.7% vs. 28.5%; <i>p</i> < 0.001). Delirium increased the risk of death, with an OR of 3.71 (95% CI 2.16–6.89; <i>p</i> < 0.001). Age, chronic atrial fibrillation, elevated INR, urea, and procalcitonin, as well as decreased phosphates, appeared to be the independent risk factors for delirium occurrence. Conclusions: Delirium occurrence in patients with severe COVID-19 significantly increases the risk of death and is associated with a cardiovascular burden. Hypophosphatemia is a promising reversible factor to reduce mortality in this group of patients. However, larger studies are essential in this area.https://www.mdpi.com/2077-0383/12/15/5049deliriumCOVID-19ICU |
| spellingShingle | Mateusz Gutowski Jakub Klimkiewicz Andrzej Michałowski Michal Ordak Marcin Możański Arkadiusz Lubas ICU Delirium Is Associated with Cardiovascular Burden and Higher Mortality in Patients with Severe COVID-19 Pneumonia Journal of Clinical Medicine delirium COVID-19 ICU |
| title | ICU Delirium Is Associated with Cardiovascular Burden and Higher Mortality in Patients with Severe COVID-19 Pneumonia |
| title_full | ICU Delirium Is Associated with Cardiovascular Burden and Higher Mortality in Patients with Severe COVID-19 Pneumonia |
| title_fullStr | ICU Delirium Is Associated with Cardiovascular Burden and Higher Mortality in Patients with Severe COVID-19 Pneumonia |
| title_full_unstemmed | ICU Delirium Is Associated with Cardiovascular Burden and Higher Mortality in Patients with Severe COVID-19 Pneumonia |
| title_short | ICU Delirium Is Associated with Cardiovascular Burden and Higher Mortality in Patients with Severe COVID-19 Pneumonia |
| title_sort | icu delirium is associated with cardiovascular burden and higher mortality in patients with severe covid 19 pneumonia |
| topic | delirium COVID-19 ICU |
| url | https://www.mdpi.com/2077-0383/12/15/5049 |
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