Intensive care delirium related to COVID-19: Risk factors, prevention and treatment policies

Year 2021, Volume: 8 Issue: 2, 152 - 155, 01.06.2021

Yeter Çuvadar Ayşe Çuvadar

Abstract

The new type of corona virus, COVID-19, which causes SARS-CoV-2, emerged as a public health threat in December 2019 and was declared an epidemic by the World Health Organization in March 2020. Delirium is frequently encountered in intensive care patients; Organic brain syndrome or intensive care syndrome, which is defined as a form of psychosocial reactions involving hallucination, anxiety and anxiety. Given the early opinions about the physiopathology of the virus and the new interventions to treat critical patients, the prevention and management of delirium will be extremely challenging, especially in the intensive care unit. However, early diagnosis of patients with delirium is critical in COVID-19 patients because delirium formation may be an early
sign of worsening respiratory failure or the corona virus reaching the central nervous system. In this review, prevention policies will be discussed by determining the importance and potential risk factors of delirium that will develop during the difficulties associated with SARS -CoV-2 infection of healthcare professionals.

Keywords

COVID-19, Delirium, Intensive Care

COVID-19 ile ilişkili yoğun bakım deliryumu: Risk faktörleri, önleme ve tedavi politikaları

Abstract

Yeni tip koronavirüs, SARS-CoV-2'ye neden olan COVID-19, Aralık 2019'da bir halk sağlığı tehdidi olarak ortaya çıkmış ve Mart 2020'de Dünya Sağlık Örgütü tarafından bir salgın olarak ilan edilmiştir. Deliryum yoğun bakım hastalarında sık karşılaşılan; halüsinasyon, anksiyete ve kaygıyı içeren psikososyal reaksiyonların bir çeşidi olarak tanımlanmış organik beyin sendromu veya yoğun bakım sendromu’dur. Virüsün fizyopatolojine ve kritik hastaları tedavi etmek için ortaya çıkan yeni müdahalelere ilişkin erken görüşler göz önüne alındığında, deliryumun önlenmesi ve yönetimi, özellikle yoğun bakım ünitesinde son derece zorlayıcı olacaktır. Fakat deliryumlu hastaların erken teşhisi COVID-19 hastalarında kritik öneme sahiptir çünkü deliryum oluşumu, solunum yetmezliğinin kötüleşmesinin veya koronavirüsün merkezi sinir sistemine ulaştığının erken bir belirtisi olabilir. Bu derlemede, sağlık profesyonellerinin SARS-CoV-2 enfeksiyonu ile ilişkili zorluklar sırasında gelişecek deliryumun önemini ve potansiyel risk faktörlerini belirleyerek önleme politikaları tartışılacaktır.

Keywords

COVID-19, Deliryum, Yoğun Bakım

References

• 1. World Health Organization. (2020) Mental Health and Psychosocial Considerations During The COVID-19 Outbreak, (Erişim Tarihi:14.04.2020) WHO/2019-nCoV/MentalHealth/2020.1 2. Öztürk, O., Uluşahin, A. (2016). Ruh Sağlığı ve Bozuklukları. Nobel Tıp Kitapevi, Ankara. 3. Kotfis, K. et al. (2020). COVID-19: What do we need to know about ICU delirium during the SARS-CoV-2 pandemic?. Anaesthesiol Intensive Ther, 52(2), 1-7. 4. Steardo, L. et al. (2020). Neuroinfection may contribute to pathophysiology and clinical manifestations of COVID-19. Acta Physiologica, 00, 1-4. 5. Kotfis, K. et al. (2020). COVID-19: ICU delirium management during SARS-CoV-2 pandemic. Critical Care, 24(176), 1-9. 6. Girard, T.D. et al. (2018). Clinical phenotypes of delirium during critical illness and severity of subsequent long-term cognitive impairment: a prospective cohort study. Lancet Respir Medicine, 6, 213-222. 7. Spronk, P.E., Riekerk, B., Hofhuis, J., Rommes, J.H. (2009). Occurrence of delirium is severely underestimated in the ICU during daily care. Intensive Care Medicine, 35, 1276-1280. 8. Ely, E.W. et al. (2004). Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA, 291, 1753-1762. 9. Vasilevskis, E.E. et al. (2018). The cost of ICU delirium and coma in the intensive care unit patient. Medicine Care, 10(56), 890-897. 10. Lahue, S., James, T., Newman, J., Esmaili, A., Ormseth, C., Ely, E. (2020.) Collaborative Delirium Prevention in the Age of COVID-19. Journal of the American Geriatrics Society. 11. Mack, A., Schofield, H.L. (2020). Applying (or not?) CAR-T Neurotoxicity Experience to COVID19 Delirium and Agitation. Journal Pre-proof, 3182(20). 12. Desai, S., Chau, T., George, L. (2013). Intensive Care Unit Delirium. Critical Care Nursing Q, 36, 370–89. 13. Sayed Abusaad, F.E., Mostafa, M.F., Wehedy Ibraheim, A.E. (2017). Learning Needs Assessment of Pediatric Nurses Regarding Delirium and Its Barriers of Screening at Intensive Care Units. American Journal of Nursing Research, 5(3), 70-78. 14. Girard, T.D.et al. (2010). Delirium as a predictor of long-term cognitive impairment in survivors of critical illness. Critical Care Medicine, 38, 1513-1520. 15. Li, Y.C. et al. (2013). Neurotropic virus tracing suggests a membranous-coatingmediated mechanism for transsynaptic communication. Journal of Comp Neurology, 521(1), 203–12. 16. Wang, Y.Y. et al. (2019). Effect of the Tailored, Family-Involved Hospital Elder Life Program on Postoperative Delirium and Function in Older Adults: A Randomized Clinical Trial. JAMA Intern Med.