Delirium: Scary Long-Term Effect in Patients With Severe COVID-19 Emerges

Recent reports have emerged that severe COVID-19 effects include 'unusually persistent delirium', an acutely disturbed state of mind that can be caused by several disorders.

It turns out that being severely infected by COVID-19 virus also triggers similar traits to the sickest hospitalized patients, up to 80% of ICU patients, according to initial investigations. Loss of oxygen to the brain or widespread inflammation are considered as some of the contributing factors to the 'confusional state'.

A single hospital in the state of Michigan reported more evidences that delirium is a very common symptom of the infection, hindering more to patient's fast recovery, more likely slowing it.

From medical records and discharge surveys from 148 patients admitted into the ICU between March and May 2020, 70% exhibited prolonged disturbance in their mental abilities. Delirium lasted for days in most cases, but nearly a third of those patients left the hospital without demonstrating full recovery.

A threat of cognitive impairment

The study did not specifically say if the delirium will have permanent or long-term impacts, but signs of cognitive impairment suggests that it reduces ability of COVID-ill patients to look after themselves after the discharge, which is why nearly half required skilled nursing care to get by at home according to two-month follow-up phone surveys. However, it seems like an unusual number of neurological symptoms can persist for six months or more.

"These results align with previous data demonstrating a high incidence of delirium in critically ill patients with COVID-19," the authors conclude. "Moreover, the median duration of delirium (10 days) is relatively long compared with other critically ill populations."

Whether these severe impairments are result of the SARS-CoV-2 virus itself or a sign of critical illness in broader manner is not fully known.

Generally, 20 percent of patients in acute care facilities exhibit cognitive impairment, but the "current pandemic seems to have at least tripled that number."

Prevention is still better than cure

"Overall, this study highlights another reason why getting vaccinated and preventing severe illness is so important," says anesthesiologist Phillip Vlisides from Michigan Medicine. "There can be long term neurological complications that perhaps we don't talk about as much as we should."

According to Michigan researchers, ICU patients infected with the coronavirus had been experiencing 'considerable neuropsychological burden' both during before and after hospital admission.

These serious cognitive impairments had not been properly addressed earlier in the pandemic, as it was rarely introduced. However, taking this into consideration might lessen prolonged hospitalization and illness recovery which is generally associated with delirium.

"Whatever creative ways we can implement delirium prevention protocols is likely to be very helpful," says Vlisides. "That includes consistent communication with family members, bringing in pictures and objects from home, and video visits if family cannot safely visit."

Researchers in Michigan found that patients more vulnerable to delirium group are from racial and ethnic minority communities and female patients, while male patients in the ICU are more susceptible to cognitive impairment.