Delirium is the main symptom of coronavirus for 16% elderly people and 25% of all seniors with COVID-19 become confused, study finds
- Researchers analyzed 817 elderly coronavirus patients who were admitted to ERs at seven hospital across five states
- More than one in four, or 28% were diagnosed with delirium, which is a state of confusion characterized by disorientation and inattention
- About 37% of patients with delirium never developed any other COVID-19 symptoms and it was the main symptom for 16%
- Delirious patients were 1.67 times more likely to be admitted to the ICU and 29% more likely to die from coronavirus
Delirium may be an early symptom of the novel coronavirus in older adults,, a new study suggests.
Researchers found more than one in four elderly patients with COVID-19 experienced confused thinking and a reduced awareness of their surroundings before any other symptom of the virus.
What’s more, nearly 40 percent never develop any other symptoms, such as cough or fever, and for nearly 20 percent of patients, delirium is the primary symptom.
The team, led by Massachusetts General Hospital and the University of Massachusetts Medical School, says the findings provide evidence for why it’s important for doctors and nurses to be trained in recognizing the signs of delirium and testing for coronavirus in those patients.
In a new study, out of 817 elderly coronavirus patients, 28% were diagnosed with delirium, which is a state of confusion characterized by disorientation and inattention. Pictured: A firefighter (left) and a paramedic (right) move an elderly patient into an ambulance in Los Angeles, July 2020
Delirium in a state of confusion characterized by an altered level of consciousness, disorientation and inattention.
Anecdotal reports and case series have detailed incidents in which older COVID-19 patients arrive at the hospital in state of delirium with no other signs or symptoms.
Early coronavirus research estimated rates of delirium were between 25 percent and 33 percent in hospitalized patients and 65 percent in ICU patients.
The researchers say that up to two-thirds of delirium cases go undetected by ER staff, increasing patients’ risk of hospitalization and death.
For the study, published in JAMA Network Open, the team looked at 817 older adults who were admitted to ERs at seven hospitals across the US for possible coronavirus infection on or after March 13.
All 817 patients, who were 65 years old or older, all tested positive for COVID-19.
More than one quarter – or 28 percent – were diagnosed with delirium, which is the sixth most common coronavirus symptom.
Additionally, more than one-third of those patients, or 37 percent, only had delirium and never developed any other symptoms such as cough, fever or shortness of breath.
What’s more, delirium was the main presenting symptom in 16 percent of those patients.
Patients were more likely to be diagnosed with delirium if they were above age 75, lived in a nursing home or assisted living facility, were visually or hearing impaired or had taken psychoactive medication in the past.
For example, adults aged 75 or older had a 51 percent higher risk for delirium and patients with a vision impairment had a 98 percent higher risk.
Delirious patients were 1.67 times more likely to be admitted to the ICU than those without the condition.
COVID-19 sufferers with delirium were also 29 percent more likely to die from the disease than those without it.
Researchers say the findings highlight the need for clinicians to recognize the signs of delirium and, if patients have them, test for the coronavirus immediately.
‘One of our main messages, especially right now, is to really try to screen everyone, older adults especially,’ co-author Benjamin Helfand, and MD-PhD candidate at the University of Massachusetts Medical School, told STAT News.
‘People coming in with even these atypical symptoms still should be screened and tested for Covid.’