More than a year after the COVID-19 pandemic, researchers are revealing the many devastating consequences that patients can face during and after hospitalization. The most recent; delirium and depression.
Cognitive impairment (delirium and depression) in patients with severe COVID
A study focused on people who suffered severe COVID-19, and required hospitalization in the Intensive Care Unit (ICU). It found that in these patients, cognitive decline is very likely and its effects can be long-lasting.
More specifically, the researchers found that 73% of the participants had delusions. A serious mental disorder characterized by confusion, agitation, and an inability to think clearly.
ABOUT THE STUDY:
Using patient medical records and telephone surveys after discharge from a group of patients hospitalized in the intensive care unit between March and May 2020. The study team attempted to identify common threads among patients who developed delirium.
The disease itself can cause a reduction in oxygen to the brain. As well as the development of blood clots and strokes, resulting in cognitive decline.
Furthermore, inflammatory markers increased considerably in patients with delirium. In this sense, confusion and agitation can be the result of inflammation of the brain.
Standard delirium prevention protocols are difficult to perform
However, care teams were sadly often unable to perform standard delirium reduction techniques. As exercises designed to make a patient move or allow visitors or household objects to orient patients while they were in the hospital.
Vlisides, one of the researchers said: “At the beginning of the pandemic, we were not performing the standard delirium prevention protocols as we routinely do. A big reason for this is at the beginning of the pandemic in the pre-vaccine era, we had limited personal protective equipment and we were trying to limit COVID exposure and disease transmission. “
Correlation between sedative use and delirium
Furthermore, there was a correlation between sedative use and delirium: delirium patients were sedated more frequently and more frequently at higher doses.
“It is common to use intravenous sedatives in the ICU, particularly for ventilator patients. However, in speaking with the nurses, we found that the severe COVID patients were inherently more delusional and agitated at the start of the study, perhaps leading to increased use of sedatives. “
The study also found that cognitive decline can persist even after discharge. Almost a third of the patients did not have their delirium marked as resolved in their chart upon leaving the hospital, and 40% of these patients required skilled nursing care.
In addition, a quarter of the patients tested positive for delirium as assessed by their caregiver. For some patients, these symptoms lasted for months. This can make managing the recovery process after hospitalization much more difficult.
What to do besides getting vaccinated …
With these results, the authors argue that whatever creative way delirium prevention protocols can be implemented, it will likely be very helpful.
That includes constant communication with family members, bringing pictures and objects from the home, and video visits if the family cannot safely do so in person.
Overall, this study highlights another reason why getting vaccinated and preventing serious illness is so important. There may be long-term neurological complications that we may not talk about as much as we should.
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