Delirium Occurs Often in Older Adults With COVID-19

Healio reports that a study published in JAMA found delirium to be a common symptom among older adults with COVID-19 presenting to U.S. emergency departments (EDs), often observed in lieu of other typical symptoms. The multicenter cohort analysis involved seven U.S. sites, with participants including consecutive older adults presenting to the ED on or after March 13, 2020. The authors used a validated chart review tool to diagnose delirium, which Harvard Medical School Professor Maura Kennedy said "was necessary as most emergency departments do not routinely screen for delirium," and because research staff could not screen for delirium on account of COVID-19 restrictions. Among 817 older patients with COVID-19, 226 had symptoms of delirium at presentation, and Kennedy said incidence of delirium was "two to four times higher than most ED studies of delirium prior to the COVID-19 pandemic." Delirium also was the primary symptom in 37 patients and happened without fever, shortness of breath, or other typical signs and symptoms of COVID-19 in 84 subjects. Despite the frequency of delirium in the study cohort, Kennedy said "it is not clear whether this is because COVID-19 infection is more likely to precipitate delirium than other disease processes or because our study had a large number of individuals at higher risk of developing delirium. I suspect it is a combination of these two factors."