A study published today in JAMA Network Open shows that 28% of older COVID-19 patients at seven US emergency departments (EDs) had delirium, putting them at higher risk of an intensive care unit (ICU) stay and death. A research team led by Massachusetts General Hospital scientists found that, of 817 COVID-19 patients 65 and older arriving at EDs, 226 (28%) had delirium, which was the sixth most common of all signs and symptoms. Delirium was a primary symptom in 37 (16%) of patients with delirium. Eighty-four patients with delirium (37%) had no typical COVID-19 symptoms, such as fever or shortness of breath. (Older adults are less likely than younger people to respond to infection with a fever.) Delirium, which involves confusion, impaired consciousness, disorientation, lack of attention, agitation, and other cognitive problems, affects mainly older people, although it’s estimated to remain undiagnosed in two thirds of patients, the researchers said. In older patients with non-coronavirus infections, delirium may be the first or only sign of illness.

 

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