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

Russotto,Ylenia; Micali,Cristina; Calabrese,Vincenzo; Nunnari,Giuseppe; Rullo,Emmanuele Venanzi; Semproni,Camilla Proietti

doi:10.3892/wasj.2022.178

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

Authors:
- Ylenia Russotto
- Cristina Micali
- Vincenzo Calabrese
- Giuseppe Nunnari
- Emmanuele Venanzi Rullo
- Camilla Proietti Semproni
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Affiliations: Unit of Infectious Diseases, University of Messina, I-98124 Messina, Italy, Unit of Nephrology and Dialysis, Department of Clinical and Experimental Medicine, University of Messina, I-98124 Messina, Italy, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, I-98124 Messina, Italy
Published online on: December 2, 2022 https://doi.org/10.3892/wasj.2022.178
Article Number: 1
Copyright: © Russotto et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

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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