Functional and cognitive outcomes after COVID-19 delirium

Key summary pointsAim To investigate functional and cognitive outcomes among patients with delirium in COVID-19. Findings Delirium in COVID-19 was prevalent (42%), but only a minority had been recognised by the clinical team. At 4-week follow-up, delirium was significantly associated with worse functional outcomes, independent of pre-morbid frailty. Cognitive outcomes were not appreciably worse. Message The presence of delirium is a significant factor in predicting worse functional outcomes in patients with COVID-19. Purpose To ascertain delirium prevalence and outcomes in COVID-19. Methods We conducted a point-prevalence study in a cohort of COVID-19 inpatients at University College Hospital. Delirium was defined by DSM-IV criteria. The primary outcome was all-cause mortality at 4 weeks; secondary outcomes were physical and cognitive function. Results In 71 patients (mean age 61, 75% men), 31 (42%) had delirium, of which only 12 (39%) had been recognised by the clinical team. At 4 weeks, 20 (28%) had died, 26 (36%) were interviewed by telephone and 21 (30%) remained as inpatients. Physical function was substantially worse in people after delirium - 50 out of 166 points (95% CI - 83 to - 17,p = 0.01). Mean cognitive scores at follow-up were similar and delirium was not associated with mortality in this sample. Conclusions Our findings indicate that delirium is common, yet under-recognised. Delirium is associated with functional impairments in the medium term.