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- A recent study published in JAMA Neurology found that neurological symptoms were present in almost
40 percent of people with COVID-19 in Wuhan, China. - Studies suggest a third to more than
80 percent of ICU patients experience delirium during their stay. - People with delirium in the ICU are also more likely to have a long-term illness.
cognitive damage and they are less likely to survive.
Although COVID-19 specifically targets the lungs, the damage it causes can include other major organs, especially the brain.
“Many COVID-19 patients have been reported to have neurological symptoms, such as headaches, confusion, seizures, and even strokes,” Dr. Halim Fadil, neurologist and movement disorders specialist at Texas Health Arlington Memorial, told Healthline Hospital.
A recent study published in JAMA Neurology found that neurological symptoms were present in almost
The treatment for people with severe symptoms of COVID-19 is often based on ventilators to help with breathing and a powerful and long-term effect.
However, these life-saving measures also come with side effects that include confusion, an inability to understand what’s going on around you, and an inability to focus.
Commonly affecting people in intensive care units (ICUs) placed on ventilators, these symptoms indicate an acute brain condition called “
“Delirium is an acute and fluctuating alteration of consciousness and cognition,” explained Fadil.
“Delirious patients may have auditory hallucinations, visual hallucinations, disorientation of time and space, agitation, aggression, fluctuating level of consciousness, and impairment of the sleep-wake cycle,” said Dr. Kevin Conner, neurologist at Texas Health Arlington. Memorial Hospital and Texas Health Physicians Group.
He explains that “lung fatigue can cause poor ventilation,” which leads to an accumulation of carbon dioxide. This can cause “metabolic disorders, confusion and drowsiness.”
According to Conner, patients with delirium may also experience memory and speech difficulties that are “tangential, disorganized, or inconsistent.”
Studies suggest that between a third and more of
Conner says that most ICU patients will experience some level of delirium during their treatment, and that “delirium can be caused by any serious illness, such as sepsis, fever, infection, organ failure, etc.”
He adds that although COVID-19 can cause delirium by affecting the lungs and reducing oxygen to the brain, the high fevers caused by the virus are also a risk factor.
Fadil says the virus probably has “neuroinvasive capabilities, because other coronaviruses have been found to invade the brain.”
Many patients with COVID-19 have been reported to have neurological symptoms such as headache, confusion, seizures, and even strokes.
Dr. Sharon K. Inouye, a professor of medicine at Harvard Medical School, created the most widely used checklist in the world to identify delirium. He developed a program used by hundreds of hospitals to reduce cases of delirium by almost 50 percent.
Called the Hospital Elderly Life Program (HELP), the goals of the checklist include:
- Maintain physical and cognitive functioning during hospitalization.
- maximizing independence at discharge
- helping with the transition from hospital to home
Conner confirms that the risk of delirium “can be reduced by early treatment of the underlying causes.” He says this includes maintaining adequate oxygen levels, reducing fever and “evaluating medications that may contribute to delirium.”
Also, avoiding benzodiazepines and antipsychotic medications, such as haloperidol (Haldol), may help.
“We are seeing a delirium epidemic in COVID-19 patients globally, and it is being poorly managed,” Inouye said in a statement.
She believes that more must be done to prevent delirium.
“A lot of that may be unavoidable: When you try to keep someone alive, you may not follow best practices for delirium prevention, so we can understand that, but I think by talking to colleagues, you can avoid it. ,” she said.
Conner emphasizes that it is important “to minimize disturbances of the sleep-wake cycle”, and that patients should be kept in a calm environment with “frequent guarantees, tact and reorientation”.
But studies also find
“Some ICUs are doing this because studies show that walking increases oxygen saturation and makes patients quit ventilators faster, which frees machines for other patients,” Inouye said in the statement. “It takes three staff members to help walk, but it can be done.”
Although it primarily affects the lungs, COVID-19 can also influence the brain. This, and being placed in the ICU for severe symptoms of COVID-19, can cause a condition called delirium.
Symptoms of delirium include confusion, memory problems, and disorientation. However, experts say it can be prevented and treated.
Exercise, even while on a ventilator, has been shown to reduce the risk of delirium. The risk can also be reduced by minimizing discomfort in the patient’s sleep cycle and keeping him in a calm and reassuring environment.
