Coronavirus: Half of current cases 'unrecognised' says expert

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Covid researchers have been revealing the often devastating consequences patients have faced during and after hospitalisation. In a new study of nearly 150 patients hospitalised for Covid at the beginning of the pandemic, it was found 73 percent had delirium – a serious disturbance in mental state which may cause a patient to become confused, agitated and unable to think clearly.

The patients with delirium tended to be sicker, with more conditions like high blood pressure and diabetes, said study author Phillip Vlisides of the Department of Anesthesiology at Michigan Medicine.

They also appeared to have more severe Covid-related illness.

“COVID is also associated with a number of other adverse outcomes that tend to prolong hospitalisation and make recovery difficult,” he added.

Using patient medical records and telephone surveys following hospital discharge for a group of patients hospitalised in the intensive care unit between March and May 2020, the study’s researchers looked to identify common threads amongst patients who developed delirium.

Several factors are at play, said Vlisides.

Delirium can lead to reduced oxygen to the brain, as well as the development of blood clots and stroke, resulting in cognitive impairment.

Inflammatory markers were found to be greatly increased in patients with delirium.

Confusion and agitation could be a result of inflammation of the brain.

In addition, care teams often were unable to perform standard delirium reduction techniques, such as exercises designed to get a patient moving or allowing visitors or objects from home to orient patients while in the hospital.

Vlisides said: “Early on in the pandemic, we weren’t performing standard delirium prevention protocols like we usually do.

“A big reason for that is early on in the pandemic in the pre-vaccine era, we had limited personal protective equipment and were trying to limit Covid exposure and disease transmission.”

The study found cognitive impairment can persist even after discharge.

Almost a third of patients didn’t have their delirium marked as resolved in their chart upon leaving the hospital, and 40 percent of these patients required skilled nursing care.

Almost a quarter of patients screened positive for delirium based on assessment by their caretaker.

For some patients, these symptoms lasted for months.

“Overall, this study highlights another reason why getting vaccinated and preventing severe illness is so important,” concluded Vlisides.

“There can be long term neurological complications that perhaps we don’t talk about as much as we should.”

Delirium is also described as sudden confusion. The NHS states if a person is confused, they may:

  • not be able to think or speak clearly or quickly
  • not know where they are (feel disorientated)
  • struggle to pay attention or remember things
  • see or hear things that are not there (hallucinations)

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