key: cord-0829258-cue9e1we
authors: Jäckel, Markus; Bemtgen, Xavier; Wengenmayer, Tobias; Bode, Christoph; Biever, Paul Marc; Staudacher, Dawid Leander
title: Is delirium a specific complication of viral acute respiratory distress syndrome?
date: 2020-07-09
journal: Crit Care
DOI: 10.1186/s13054-020-03136-6
sha: 5c17eca0e4fc83d345681775fa41b57f1ca6c3be
doc_id: 829258
cord_uid: cue9e1we

nan

ICU. The NuDesc score is approved and shows a high sensitivity and specifity [5] .

A total of 83 patients with ARDS were identified (44 and 39; with SARS-Cov-2 and influenza, respectively). Thirty-seven (22 and 15) died before extubation and 10 (2 and 8) were transferred with tracheotomia without the possibility of delirium evaluation using a verbal test. We therefore analyzed 36 (20 and 16) patients. Besides of age (patients with SARS-Cov-2 infection were significantly older), groups were homogenous (see Table 1 ).

Of all analyzed patients 69.4% (65.0 and 75.0% with SARS-CoV-2 and influenza, respectively) were diagnosed with delirium at any time during the ICU stay. Delirium duration tended to be longer in patients with SARS-CoV-2 (5.1 ± 4.3 days vs. 2.8 ± 2.4 days, p = 0.13). Delirium severity, defined as maximum of NuDesc score, also tended to be more distinctive in SARS-Cov-2 patients (NuDesc score at maximum: 5.2 ± 2.6 vs. 3.7 ± 1.8, p = 0.11). The onset of delirium after extubation was similar (0.50 ± 1.08 days vs. 0.8 ± 1.6 days). For the delirium presentation, see Fig. 1 .

In this registry study of delirium in viral ARDS, we found no statistical significant difference in de- lirium prevalence, intensity, or type of delirium comparing patients with SARS-CoV-2 to those with influenza. We therefore hypothesize that delirium observed in COVID-19 patients has to be considered a complication of ARDS rather than SARS-CoV-2 specific. Considering the retrospective nature of data presented here, our results have to be considered hypothesis generating and have to be confirmed in a larger patient collective. 

Neurologic features in severe SARS-CoV-2 infection

Neuroinvasion by human respiratory coronaviruses

COVID-19: ICU delirium management during SARS-CoV-2 pandemic

More on neurologic features in severe SARS-CoV-2 infection

Fast, systematic, and continuous delirium assessment in hospitalized patients: the nursing delirium screening scale

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Authors' contributions MJ, PB, and DS carried out the data collection, design, and planning of this study. MJ and DS performed the statistical analysis and drafted the manuscript. All authors participated in the critical discussion of the study and interpretation of data. All authors read and approved the final manuscript.

The article processing charge was funded by the Baden-Wuerttemberg Ministry of Science, Research and Art and University of Freiburg in the funding programme Open Access Publishing.

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

This retrospective study was approved by the ethics committee of the Albert Ludwigs University of Freiburg, file number 387/19.

Not applicable.

The authors declare that they have no competing interests.Received: 9 June 2020 Accepted: 1 July 2020