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One in three elderly Covid-19 patients are delirious, study finds

One in three elderly Covid-19 patients are delirious, study finds

Delirium is a common symptom of coronavirus in elderly patients, found in around one in three infected over-65s.  Researchers also say the p

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Delirium is a common symptom of coronavirus in elderly patients, found in around one in three infected over-65s.  

Researchers also say the presence of delirium as a symptom is a particularly bad omen, linked to an increased likelihood of severe disease and death. 

A US-wide study looked at 817 older patients who tested positive for the coronavirus and 226 (28 per cent) were diagnosed with delirium. 

The cohort had an average age of 78 and 84 (37 per cent) of the delirious patients did not have any typical Covid symptoms — such as a fever or shortness of breath.

Eighty-four delirious patients died in hospital and scientists say it increases the risk of death by 24 per cent and likelihood of ICU admission by 67 per cent.

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A US-wide study looked at 817 older patients who tested positive for the coronavirus and 226 (28 per cent) were diagnosed with delirium

A US-wide study looked at 817 older patients who tested positive for the coronavirus and 226 (28 per cent) were diagnosed with delirium

A US-wide study looked at 817 older patients who tested positive for the coronavirus and 226 (28 per cent) were diagnosed with delirium 

Doctors at Massachusetts General Hospital worked with scientists at Harvard to scrutinise any relationship between cases, deaths and delirium.

Delirium is a state that comes on suddenly in which people get confused, struggle to think clearly and may hallucinate, become agitated or have mood swings. 

Covid-19 causes delirium, stroke and nerve damage in ‘a higher than expected’ number of patients 

Infection with the coronavirus can cause delirium, stroke and nerve damage in ‘a higher than expected number of patients’, a study has found.

Experts from University College London have reported a ‘concerning increase’ amid the pandemic of a rare brain inflammation known to be triggered by viral infections.

Typically seen in children, acute disseminated encephalomyelitis — or ‘ADEM’, for short — affects the both the brain and spinal cord.

The condition — which can follow on from minor infections such as colds — sees immune cells activated to attack the fatty protective coating that covers nerves.

The researchers have warned that clinicians need to be aware of the risk of neurological effects to help early diagnoses and improve patient outcomes.

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The condition is caused by problems in the brain and can make people more likely to get seriously ill or die in hospital because their bodies become generally weaker and less able to recover, and the effects on the brain can be long-lasting or permanent.  

The study, published today in the journal JAMA Network Open, looked at 817 cases of Covid-19 in over-65s at seven hospitals across the US. 

Fever was the most common symptom, in more than half (56 per cent) of cases, closely followed by shortness of breath (51 per cent). 412 out of 817 patients had a cough, slightly over 50 per cent. 

Delirium was the sixth most common symptom, behind fever, coughing, weakness, hypoxia and shortness of breath.

‘Factors associated with risk of delirium included older age, prior psychoactive medication use, assisted living or skilled nursing facility residence, vision or hearing impairment, stroke, and Parkinson disease,’ the researchers write. 

‘Delirium at presentation was significantly associated with increased risk for poor hospital outcomes, including ICU stay, discharge to a rehabilitation facility, and death.’

Data reveals people over 75 are at a 51 per cent increased risk of developing delirium following infection with the coronavirus, whereas people with prior vision impairment are 98 per cent more likely than the average pensioner.  

‘Our study demonstrates that it is critical to recognise that older adults with COVID-19 may present with delirium as the primary or sole symptom,’ the researchers add. 

‘In addition, delirium is an important risk marker to identify patients at high risk for poor outcomes, including death.’

In September, experts who run the Covid Symptom Tracker app, from King’s College London, found of over-65s who ended up in hospital because of Covid-19, one in five (18.9 per cent) said delirium was their only symptom.

The researchers said the coronavirus may be able to get into the brain and infect it, affecting someone’s mental state. And delirium can also be caused by high levels of white blood cells in the brain or by fever, a separate symptom of Covid-19. 

Dr Rose Penfold, an epidemiologist at King’s, said: ‘Older, frailer people are at greater risk from Covid-19 than those who are fitter, and our results show that delirium is a key symptom in this group.

‘Doctors and carers should watch out for any changes in mental state in elderly people, such as confusion or strange behaviour, and be alert to the fact that this could be an early sign of coronavirus infection.’

Although delirium can cause similar symptoms to dementia or simply age-related brain decline, it usually comes on quickly and makes a noticeable difference.

It may happen in people who are otherwise mentally healthy, or worsen problems in people who already have them. 

Symptoms in elderly patients  
Symptoms Number of patients(total = 817) Percentage of patients with symptom
Fever 459 56
Shortness of breath 420 51
Cough 412 50
Hypoxia 324 40
Weakness 241 30
Delirium 226 28
Fatigue 210 26
Diarrhoea 130 16
Anorexia 122 15
Eighty-four delirious patients died in hospital and scientists say it increases the risk of death by 24 per cent and likelihood of ICU admission by 67 per cent

Eighty-four delirious patients died in hospital and scientists say it increases the risk of death by 24 per cent and likelihood of ICU admission by 67 per cent

Eighty-four delirious patients died in hospital and scientists say it increases the risk of death by 24 per cent and likelihood of ICU admission by 67 per cent 

A July paper from UCL found infection with the coronavirus can cause delirium, stroke and nerve damage in ‘a higher than expected number of patients’.

Experts reported a ‘concerning increase’ amid the pandemic of a rare brain inflammation known to be triggered by viral infections.

Typically seen in children, acute disseminated encephalomyelitis — or ‘ADEM’, for short — affects the both the brain and spinal cord.

The condition — which can follow on from minor infections such as colds — sees immune cells activated to attack the fatty protective coating that covers nerves.

The researchers have warned that clinicians need to be aware of the risk of neurological effects to help early diagnoses and improve patient outcomes.

‘We identified a higher than expected number of people with neurological conditions such as brain inflammation,’ said paper author and consultant neurologist Michael Zandi of the University College London.

‘We should be vigilant and look out for these complications in people who have had COVID-19.

‘Whether we will see an epidemic on a large scale of brain damage linked to the pandemic — perhaps similar to the encephalitis lethargica outbreak in the 1920s and 1930s after the 1918 influenza pandemic — remains to be seen.’ 

Coronavirus-infected man confesses to his wife that he used to have sex with men ‘after Covid-19 made him delirious’

A man who became manic after being infected with coronavirus got so delirious he confessed to his wife that he used to have sex with men, doctors have revealed.

The unidentified 41-year-old, who was treated at St Thomas’ Hospital in London, also became ‘highly aroused’ and uninhibited, questioning and inappropriately touching nurses tasked with treating him.

He also became obsessed with ‘grandiose ideas’ and tried to smear water on fellow patients as if he were baptising them, medics said in a bizarre case report. 

The man was sick with a cough and fever for 10 days before he ended up in hospital and tested positive for Covid-19, which doctors believe triggered unusual symptoms.

He eventually had to be sectioned under the Mental Health Act because he became so out of control.

Describing the experience in his own words after recovering as ‘fascinating’, the man said he thought he was ‘trying to help the doctors as much as I could’.

He added: ‘I began to think that I was part of a TV show, in which I was sent back from the future to save the NHS, and I was curious to see how this would end.’

The doctors said it was possible his episode was the first sign of a condition such as bipolar disorder — but did not diagnose him with that and instead put it down to the coronavirus despite admitting they can’t prove it for certain.

One mental health expert told MailOnline it is well documented that immune system reactions can affect the brain and trigger mania such as what the man suffered, calling his episode ‘bizarre but not extreme’.    

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This post first appeared on Dailymail.co.uk

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