Aim

Delirium is a common presenting symptom among older patients. Patients who presented with delirium may have a higher morbidity and mortality rate due to older age, other comorbidities, and atypical COVID-19 presentation. Currently, the evidence supporting delirium as one of the predictors of poor outcome of COVID-19 is still insufficient. This study aims to explore the potential association between delirium and poor outcomes from COVID-19.

Methods

We systematically searched the PubMed and Google Scholar databases using specific keywords related to our aims until January 30th, 2021. All articles published on COVID-19 and delirium were retrieved. The quality of the study was assessed using the Newcastle Ottawa Scale (NOS) tool for observational studies and Joanna Briggs Institute (JBI) Critical Appraisal Tools for case-series studies. Statistical analysis was done using Review Manager 5.4 software.

Results

Our meta-analysis of 20 studies showed that delirium symptoms on admission was associated with poor outcomes from COVID-19 [OR 2.36 (95% CI 1.80–3.09), p < 0.00001, I² = 76%, random-effect models] and its subgroup which consist of severe COVID-19 [OR 3.89 (95% CI 1.72–8.75), p = 0.001, I² = 91%, random-effect models], and mortality from COVID-19 [OR 1.90 (95% CI 1.55–2.33), p < 0.00001, I² = 36%, random-effect models]. Meta-regression showed that the association was influenced by age (p = 0.005).

Conclusions

Our study suggests delirium as an important marker to identify patients at higher risk for developing poor COVID-19 outcomes. The physicians should add delirium as one of the common presenting symptoms of COVID-19 in older populations.

中文翻译：

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谵妄是 2019 年冠状病毒病 (COVID-19) 肺炎不良预后的良好预测指标：一项系统评价、荟萃分析和荟萃回归

目标

谵妄是老年患者的常见症状。由于年龄较大、其他合并症和非典型 COVID-19 表现，出现谵妄的患者可能具有更高的发病率和死亡率。目前，支持谵妄作为 COVID-19 预后不良的预测因素之一的证据仍然不足。本研究旨在探讨谵妄与 COVID-19 不良后果之间的潜在关联。

方法

截至 2021 年 1 月 30 日，我们使用与我们的目标相关的特定关键字系统地搜索了 PubMed 和 Google Scholar 数据库。检索了所有发表在 COVID-19 和 delirium 上的文章。使用用于观察研究的纽卡斯尔渥太华量表 (NOS) 工具和用于案例系列研究的 Joanna Briggs Institute (JBI) 批判性评估工具评估研究的质量。使用 Review Manager 5.4 软件进行统计分析。

结果

我们对 20 项研究的荟萃分析表明，入院时的谵妄症状与 COVID-19 的不良结局相关[OR 2.36 (95% CI 1.80–3.09)，p  < 0.00001，I ²  = 76%，随机效应模型]和它的亚组由严重的 COVID-19 [OR 3.89 (95% CI 1.72–8.75)，p  = 0.001，I ²  = 91%，随机效应模型]和 COVID-19 死亡率 [OR 1.90 (95% CI 1.72–8.75) 1.55–2.33), p  < 0.00001, I ²  = 36%, 随机效应模型]。元回归表明该关联受年龄影响 (p = 0.005)。

结论

我们的研究表明，谵妄是识别 COVID-19 预后较差风险较高的患者的重要标志。医生应将谵妄添加为老年人群中 COVID-19 的常见症状之一。