Delirium occurrence and association with outcomes in hospitalized COVID-19 patients

Pagali, Sandeep R.; Fu, Sunyang; Lindroth, Heidi; Sohn, Sunghwan; Burton, M. Caroline; Lapid, Maria I.

doi:10.1017/s104161022100106x

Cited by 9 publications

(17 citation statements)

References 9 publications

(22 reference statements)

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“…With a mean age of 81.7±4 years and a huge prevalence of the male sex, the cases described in the present study appear to follow the evidence in the literature, which report a greater risk of developing delirium in males and among the elderly, a well as among patients hospitalized for COVID-19 (75)(76)(77)(78)(79).…”

Section: Discussionsupporting

confidence: 86%

Delirium during COVID‑19: A report of eight cases and a review of the literature

et al. 2022

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Delirium is an acute confusional state, often associated with long-term hospitalization, oxygen supplementation, the male sex and an older age. Since the start of the coronavirus disease 2019 (COVID-19) pandemic, there was an abrupt increase in intensive care unit (ICU) admissions and hospitalization in general, as well as in the need for oxygen therapy and enforced isolation due to the contagion risk. This caused a sudden increase in the episodes of delirium. The diagnosis of delirium, however, remains a difficult task, as it can often be misdiagnosed or confused with underlying dementia, particularly among the elderly. The present study describes present eight cases of patients admitted to hospital due to severe acute respiratory syndrome coronavirus 2 infection, who manifested delirium. Notably, only one of the patients had psychiatric comorbidities prior to hospitalization. The most prevalent sex was the male (7:1) one, the mean age of the patients was 81.7±4 years, and the mean duration of hospitalization was 23.6±6 days. In total, 3 patients had a virological recovery and were discharged, 3 had a clinical recovery and were transferred to a lower intensity COVID-19 facility and 2 patients did not survive. In the eight cases described herein, the mortality rate was 25%. Delirium was found to be commonly associated with a higher mortality rate and a longer hospitalization period. Therefore, it is imperative to develop protocols and tools with which to rapidly assess delirium and treat it accordingly. In addition, it is fundamental to improve the quality of life of hospitalized patients, supporting behavioral therapy and the environmental factors that can affect patients, to prevent delirium as well.

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Section: Discussionsupporting

confidence: 86%

Delirium during COVID‑19: A report of eight cases and a review of the literature

et al. 2022

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“…The unstructured clinical notes and semi-structured flowsheet data can improve phenotyping sensitivity by approximately 20% over a purely structured data (ICD-based) approach. [8][9][10] Similar results were achieved with incidental findings, 11 diseases with multifactorial causes, 9,12 diseases with no singular and conclusive diagnostic tests, 13 or surgical information. 13,14 Furthermore, to maximize the detection accuracy, studies have leveraged the combination of both structured (e.g., laboratory and medication) and unstructured data to determine patient's disease status, such as silent brain infarction, 15 type 2 diabetes mellitus, 16 and rheumatoid arthritis.…”

Section: Introductionsupporting

confidence: 70%

Recommended practices and ethical considerations for natural language processing‐assisted observational research: A scoping review

Wang

Moon

et al. 2022

Clinical Translational Sci

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An increasing number of studies have reported using natural language processing (NLP) to assist observational research by extracting clinical information from electronic health records (EHRs). Currently, no standardized reporting guidelines for NLP‐assisted observational studies exist. The absence of detailed reporting guidelines may create ambiguity in the use of NLP‐derived content, knowledge gaps in the current research reporting practices, and reproducibility challenges. To address these issues, we conducted a scoping review of NLP‐assisted observational clinical studies and examined their reporting practices, focusing on NLP methodology and evaluation. Through our investigation, we discovered a high variation regarding the reporting practices, such as inconsistent use of references for measurement studies, variation in the reporting location (reference, appendix, and manuscript), and different granularity of NLP methodology and evaluation details. To promote the wide adoption and utilization of NLP solutions in clinical research, we outline several perspectives that align with the six principles released by the World Health Organization (WHO) that guide the ethical use of artificial intelligence for health.

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“…Studies of delirium to date in patients with COVID‐19 have suggested prevalence rates from 12% to 84% [30–32]. This disparity reflects the challenges in recognition and the diversity of settings.…”

Section: Prevalence and Incidencementioning

confidence: 99%

“…Studies of delirium to date in patients with COVID-19 have suggested prevalence rates from 12% to 84% [30][31][32].…”

Section: Prevalence and Incidencementioning

confidence: 99%

Delirium and COVID‐19: a narrative review of emerging evidence

McCluskey

Jackson

2022

Anaesthesia

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Delirium is a common condition affecting hospital inpatients, including those having surgery and on the intensive care unit. Delirium is also common in patients with COVID-19 in hospital settings, and the occurrence is higher than expected for similar infections. The short-term outcomes of those with COVID-19 delirium are similar to that of classical delirium and include increased length of stay and increased mortality. Management of delirium in COVID-19 in the context of a global pandemic is limited by the severity of the syndrome and compounded by the environmental constraints. Practical management includes effective screening, early identification and appropriate treatment aimed at minimising complications and timely escalation decisions. The pandemic has played out on the national stage and the effect of delirium on patients, relatives and healthcare workers remains unknown but evidence from the previous SARS outbreak suggests there may be long-lasting psychological damage.

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Delirium occurrence and association with outcomes in hospitalized COVID-19 patients

Cited by 9 publications

References 9 publications

Delirium during COVID‑19: A report of eight cases and a review of the literature

Delirium during COVID‑19: A report of eight cases and a review of the literature

Recommended practices and ethical considerations for natural language processing‐assisted observational research: A scoping review

Delirium and COVID‐19: a narrative review of emerging evidence

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