Functional and cognitive outcomes after COVID-19 delirium
Functional and cognitive outcomes after COVID-19 delirium
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DOI：
10.1007/s41999-020-00353-8
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发表时间：
2020-07-14
影响因子：
3.8
通讯作者：
Davis, Daniel
中科院分区：
文献类型：
--
作者：
Mcloughlin, Benjamin C.;Miles, Amy;Davis, Daniel
关键总结点目的研究COVID-19谵妄患者的功能和认知结局。COVID-19中的谵妄很普遍（42%），但只有少数被临床团队认可。在4周随访时，谵妄与较差的功能结局显著相关，与病前虚弱无关。认知结果并没有明显恶化。谵妄的存在是预测COVID-19患者功能结局恶化的重要因素。目的确定COVID-19患者谵妄的患病率和结局。方法我们在大学学院医院的COVID-19住院患者队列中进行了一项点患病率研究。谵妄的定义符合DSM-IV标准。主要结局是4周时的全因死亡率;次要结局是身体和认知功能。结果71例患者（平均年龄61岁，75%为男性）中，31例（42%）有谵妄，其中只有12例（39%）被临床团队识别。第4周时，20例（28%）死亡，26例（36%）接受电话采访，21例（30%）仍为住院患者。谵妄后患者的身体功能明显更差--166分中有50分（95%CI- 83至-17，p = 0.01）。随访时的平均认知评分相似，在该样本中，谵妄与死亡率无关。结论我们的研究结果表明，谵妄是常见的，但认识不足。谵妄与中期功能障碍有关。
Key summary pointsAim To investigate functional and cognitive outcomes among patients with delirium in COVID-19. Findings Delirium in COVID-19 was prevalent (42%), but only a minority had been recognised by the clinical team. At 4-week follow-up, delirium was significantly associated with worse functional outcomes, independent of pre-morbid frailty. Cognitive outcomes were not appreciably worse. Message The presence of delirium is a significant factor in predicting worse functional outcomes in patients with COVID-19.Purpose To ascertain delirium prevalence and outcomes in COVID-19. Methods We conducted a point-prevalence study in a cohort of COVID-19 inpatients at University College Hospital. Delirium was defined by DSM-IV criteria. The primary outcome was all-cause mortality at 4 weeks; secondary outcomes were physical and cognitive function. Results In 71 patients (mean age 61, 75% men), 31 (42%) had delirium, of which only 12 (39%) had been recognised by the clinical team. At 4 weeks, 20 (28%) had died, 26 (36%) were interviewed by telephone and 21 (30%) remained as inpatients. Physical function was substantially worse in people after delirium - 50 out of 166 points (95% CI - 83 to - 17,p = 0.01). Mean cognitive scores at follow-up were similar and delirium was not associated with mortality in this sample. Conclusions Our findings indicate that delirium is common, yet under-recognised. Delirium is associated with functional impairments in the medium term.