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

Jae Hoon Lee; Won Ho Han; June Young Chun; Young Ju Choi; Mi Ra Han; Jee Hee Kim

doi:10.1371/journal.pone.0289662

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

PLoS One. 2023 Nov 13;18(11):e0289662. doi: 10.1371/journal.pone.0289662. eCollection 2023.

Authors

Jae Hoon Lee¹, Won Ho Han¹, June Young Chun², Young Ju Choi², Mi Ra Han³, Jee Hee Kim⁴

Affiliations

¹ Critical Care Medicine, National Cancer Center, Goyang, South Korea.
² Department of Internal Medicine, National Cancer Center, Goyang, South Korea.
³ Biostatistics Collaboration Team, National Cancer Center, Goyang, South Korea.
⁴ Department of Anesthesiology, National Cancer Center, Goyang, South Korea.

Abstract

Coronavirus disease 2019 (COVID-19) can lead to acute organ dysfunction, and delirium is associated with long-term cognitive impairment and a prolonged hospital stay. This retrospective single-center study aimed to investigate the risk factors for delirium in patients with COVID-19 infection receiving treatment in an intensive care unit (ICU). A total of 111 patients aged >18 years with COVID-19 pneumonia who required oxygen therapy from February 2021 to April 2022 were included. Data on patient demographics, past medical history, disease severity, delirium, and treatment strategies during hospitalization were obtained from electronic health records. Patient characteristics and risk factors for delirium were analyzed. Old age (P < 0.001), hypertension (P < 0.001), disease severity (Sequential Organ Failure Assessment score) (P < 0.001), mechanical ventilator support (P < 0.001), neuromuscular blocker use (P < 0.001), and length of stay in the ICU (P < 0.001) showed statistically significant differences on the univariable analysis. Multivariable analysis with backward selection revealed that old age (odds ratio, 1.149; 95% confidence interval, 1.037-1.273; P = 0.008), hypertension (odds ratio, 8.651; 95% confidence interval, 1.322-56.163; P = 0.024), mechanical ventilator support (odds ratio, 226.215; 95% confidence interval, 15.780-3243.330; P < 0.001), and length of stay in the ICU (odds ratio, 30.295; 95% confidence interval, 2.539-361.406; P = 0.007) were significant risk factors for delirium. In conclusion, old age, ICU stay, hypertension, mechanical ventilator support, and neuromuscular blocker use were predictive factors for delirium in COVID-19 patients in the ICU. The study findings suggest the need for predicting the occurrence of delirium in advance and preventing and treating delirium.

Copyright: © 2023 Lee et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / complications
COVID-19* / therapy
Delirium* / epidemiology
Delirium* / etiology
Delirium* / therapy
Humans
Hypertension* / complications
Intensive Care Units
Length of Stay
Neuromuscular Blocking Agents*
Retrospective Studies
Risk Factors

Substances

Neuromuscular Blocking Agents

Grants and funding

Initials of the authors who received each award: WHH Grant numbers awarded to each author: NCC 2212490-2 The full name of each funder: National Cancer Center, Korea URL of each funder website: https://www.ncc.re.kr/indexEn.ncc The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.