ArticleBMJ open2021
Delirium and neuropsychological outcomes in critically Ill patients with COVID-19: a cohort study.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Mechanisms underlying neurocognitive dysfunction following critical illness: a systematic review.Anaesthesia · 2025Pooled it
- Pharmacological Treatment of Acute Psychiatric Symptoms in COVID-19 Patients: A Systematic Review and a Case Series.International journal of environmental research and public health · 2022Pooled it
- Predicting delirium in critically Ill COVID-19 patients using EEG-derived data: a machine learning approach.GeroScience · 2026Observational
- Circulating Brain-Related miRNAs as Predictors of Postoperative Delirium in Cardiac Surgery Patients.International journal of molecular sciences · 2025Article
- Incidence of Delirium in ICU Patients With and Without COVID-19 in a Costa Rican Hospital.Cureus · 2024Article
- Discovery of Delirium Biomarkers through Minimally Invasive Serum Molecular Fingerprinting.Metabolites · 2024Article
- Infectious Diseases.Advances in neurobiology · 2024Review
- Cerebrospinal fluid quinolinic acid is strongly associated with delirium and mortality in hip-fracture patients.The Journal of clinical investigation · 2023Observational
- Predictors of discharge disposition and mortality following hospitalization with SARS-CoV-2 infection.PloS one · 2023Article
- Review
- Relationship Among Clinically Obtained Biomarkers of Inflammation, Hypercoagulability, and Macrophage Activation, and Delirium in Critically Ill Patients With COVID-19.Critical care explorations · 2023Article
- Delirium in a Relatively Young Person due to COVID-19 Infection.Case reports in psychiatry · 2023Article
- [Factors Associated With Delirium In Patients Hospitalized During The COVID-19 Pandemic].Revista colombiana de psiquiatria · 2022Article
- Ischemic and Hemorrhagic Cerebrovascular Events Related to COVID-19 Coagulopathy and Hypoxemia.International journal of environmental research and public health · 2022Review
- Therapeutic Approaches to the Neurologic Manifestations of COVID-19.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2022Article
- Electroencephalogram-Based Evaluation of Impaired Sedation in Patients with Moderate to Severe COVID-19 ARDS.Journal of clinical medicine · 2022Article
- Cholinergic blockade of neuroinflammation: from tissue to RNA regulators.Neuronal signaling · 2022Review
- Delirium in hospitalized COVID-19 patients: Predictors and implications for patient outcome.PloS one · 2022Article
- Brain Imaging Changes in Patients Recovered From COVID-19: A Narrative Review.Frontiers in neuroscience · 2022Article
- Factors Associated With Severity of Delirium Complicating COVID-19 in Intensive Care Units.Frontiers in neurology · 2022Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo characterise the clinical course of delirium for patients with COVID-19 in the intensive care unit, including postdischarge neuropsychological outcomes.
designRetrospective chart review and prospective survey study.
settingIntensive care units, large academic tertiary-care centre (USA).
participantsPatients (n=148) with COVID-19 admitted to an intensive care unit at Michigan Medicine between 1 March 2020 and 31 May 2020 were eligible for inclusion. PRIMARY AND SECONDARY OUTCOME MEASURES: Delirium was the primary outcome, assessed via validated chart review method. Secondary outcomes included measures related to delirium, such as delirium duration, antipsychotic use, length of hospital and intensive care unit stay, inflammatory markers and final disposition. Neuroimaging data were also collected. Finally, a telephone survey was conducted between 1 and 2 months after discharge to determine neuropsychological function via the following tests: Family Confusion Assessment Method, Short Blessed Test, Patient-Reported Outcomes Measurement Information System Cognitive Abilities 4a and Patient-Health Questionnaire-9.
resultsDelirium was identified in 108/148 (73%) patients, with median (IQR) duration lasting 10 (4-17) days. In the delirium cohort, 50% (54/108) of patients were African American and delirious patients were more likely to be female (76/108, 70%) (absolute standardised differences >0.30). Sedation regimens, inflammation, delirium prevention protocol deviations and hypoxic-ischaemic injury were likely contributing factors, and the most common disposition for delirious patients was a skilled care facility (41/108, 38%). Among patients who were delirious during hospitalisation, 4/17 (24%) later screened positive for delirium at home based on caretaker assessment, 5/22 (23%) demonstrated signs of questionable cognitive impairment or cognitive impairment consistent with dementia and 3/25 (12%) screened positive for depression within 2 months after discharge.
conclusionPatients with COVID-19 commonly experience a prolonged course of delirium in the intensive care unit, likely with multiple contributing factors. Furthermore, neuropsychological impairment may persist after discharge.
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