Evidence map›Paper›PMID 38498073›Full record

SynthesisEuropean geriatric medicine2024

A pandemic of delirium: an updated systematic review and meta-analysis of occurrence of delirium in older adults with COVID-19.

Maria Beatrice Zazzara, Alice Margherita Ornago, Camilla Cocchi, Elisabetta Serafini, Giuseppe Bellelli, Graziano Onder

Open access · hybridAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in European geriatric medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
3.8field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Five-decade prevalence of delirium in pneumonia, risk factors and associated mortality: a systematic review and meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2025
    Pooled it
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Maria Beatrice ZazzaraFondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. mariabeatrice.zazzara@policlinicogemelli.it.ORCID 0000-0001-9155-3388
Alice Margherita OrnagoSchool of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Camilla CocchiDepartment of Aging, Orthopaedics and Rheumatological Sciences, Università Cattolica del Sacro Cuore, Rome, Italy.
Elisabetta SerafiniFondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
Giuseppe BellelliSchool of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.
Graziano OnderFondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy.
Università Cattolica del Sacro Cuore · ITAgostino Gemelli University Polyclinic · ITAzienda Ospedaliera San Gerardo · ITUniversity of Milano-Bicocca · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDelirium has been recognized as an atypical presenting feature of COVID-19 in older adults and is independently associated with mortality. We aimed to perform an updated systematic review of the literature and proportional meta-analysis to assess prevalence and incidence of delirium in older adults with COVID-19, addressing differences according to sex, frailty status, and settings.

methodsWe searched databases for English-language articles on prevalence and incidence of delirium in older adults with COVID-19, published between March 2020 and January 2023.

resultsOf the 1171 articles identified, 66 met selection criteria and were included in the meta-analysis (n = 35,035 participants, age-range 66-90 years old, 46.6% females). We observed similar pooled prevalence (20.6% [95% Confidence Interval (CI) 17.8-23.8%]) and incidence (21.3% [95% CI 14.7-30%]) of delirium. Pooled occurrence (both prevalence and incidence) of delirium was similar according to sex (females 21.3% [95% CI 16-27.5%] vs. males 23.8%% [95% CI 18.2-30.4%], p-value = 0.55) and study setting (nursing homes 22.5% [95% CI 14.2-33.6%] vs. hospital 20.3% [95% CI 17-24%], p = 0.68), but it was significantly higher in frail versus non-frail patients (37% [95% CI 26.6-48.8%] vs. 12.5% [95% CI 7.8-19.6%], p-value < 0.01). Delirium definitions and assessment tools largely varied across studies.

conclusionThis review delineates delirium as a common feature of COVID-19, particularly in frail older adults, and supports its formal inclusion among COVID-19 symptoms. The considerable heterogeneity in delirium assessment highlights the need for an operational strategy to standardize definitions and tools utilization in the management of frail older adults.

Indexed as

COVID-19DeliriumSARS-CoV-2AgedAged, 80 and overFemaleFrail ElderlyFrailtyHumansIncidenceMalePrevalenceCOVID-19DeliriumFrailtyOlder adultsSARS-CoV-2 infection

Identifiers

PMID38498073
PMCPMC10997697
OpenAlexW4392917145

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.