Risk factors for delirium in patients with COVID-19: A systematic review and meta-analysis

Abstract

Delirium is one of the serious neurological complications of Coronavirus Disease 2019 (COVID-19) and is associated with significant morbidity and mortality in patients with COVID-19, especially in older patients. There is currently no meta-analysis of risk factors for delirium in patients with COVID-19. This study aimed to identify potential risk factors for delirium in patients with COVID-19 through a meta-analysis of observational clinical studies. In conducting this analysis, literature searches were conducted in PubMed, Embase, Cochrane Library, and Web of Science, and study quality was assessed using the Newcastle-Ottawa Quality Scale (NOS). Data were extracted independently by two reviewers and pooled using either fixed effects or random effects models based on the results of heterogeneity testing. As a result of this meta-analysis, a total of 21 studies were included, including 10,147 patients. The analysis revealed the identification of 26 predisposing factors and 54 precipitating factors associated with COVID-19-related delirium. Notably, the administration of hydrocortisone and azithromycin, among other specific medications designated for COVID-19, exhibited a potential to be positively associated with the incidence of delirium in patients afflicted with COVID-19. In conclusion, the present study identified potential predisposing and precipitating factors linked with delirium in COVID-19 patients. It is anticipated that these results will have a considerable impact on the management and treatment of delirium in COVID-19 patients.

Keywords: COVID-19; Delirium; Meta-analysis; Review; Risk factors.