Functional and cognitive outcomes after COVID-19 delirium

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, 31 (42%) had delirium, of which only 19 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 (−39 points on functional scale/166, 95% CI −92 to −21, p=0.01) (Table 2). 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.

Key summary points

Aim

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.