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Delirium and health-related quality of life in severe COVID-19 survivors

Published online by Cambridge University Press:  01 September 2022

L. Chorão ,
S. Martins ,
A.R. Ferreira ,
J. Fernandes ,
T. Vieira ,
L. Fontes ,
N. Reis ,
A. Braga ,
I. Coimbra  and
J.A. Paiva
...Show all authors
L. Chorão*
Affiliation:
Faculty of Medicine of the University of Porto, Fmup, Porto, Portugal
S. Martins
Affiliation:
Faculty of Medicine - University Porto, Department Of Clinical Neuroscience And Mental Health And Center for health technology and services research (cintesis), Porto, Portugal
A.R. Ferreira
Affiliation:
Faculty of Medicine - University Porto, Department Of Clinical Neuroscience And Mental Health And Center for health technology and services research (cintesis), Porto, Portugal
J. Fernandes
Affiliation:
Centro Hospitalar Universitário São João (CHUSJ), Intensive Care Medicine Department, Porto, Portugal
T. Vieira
Affiliation:
Centro Hospitalar Universitário São João (CHUSJ), Intensive Care Medicine Department, Porto, Portugal
L. Fontes
Affiliation:
Centro Hospitalar Universitário São João (CHUSJ), Intensive Care Medicine Department, Porto, Portugal
N. Reis
Affiliation:
Centro Hospitalar Universitário São João (CHUSJ), Intensive Care Medicine Department, Porto, Portugal
A. Braga
Affiliation:
Centro Hospitalar Universitário São João (CHUSJ), Intensive Care Medicine Department, Porto, Portugal
I. Coimbra
Affiliation:
Centro Hospitalar Universitário São João (CHUSJ), Intensive Care Medicine Department, Porto, Portugal
J.A. Paiva
Affiliation:
Centro Hospitalar Universitário São João (CHUSJ), Intensive Care Medicine Department, Porto, Portugal Faculty of Medicine - University Porto, Department Of Medicine, Porto, Portugal
L. Fernandes
Affiliation:
Faculty of Medicine - University Porto, Department Of Clinical Neuroscience And Mental Health And Center for health technology and services research (cintesis), Porto, Portugal Psychiatry Service, Centro Hospitalar Universitário De São João, Porto, Portugal
*
*Corresponding author.

Abstract

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Introduction

Severe COVID-19 survivors experience long-term neuropsychiatric morbidity, particularly those who developed delirium, with a negative impact on health-related quality of life (HRQoL).

Objectives

To identify the cases of delirium in severe COVID-19 patients and to describe its association with post-hospital discharge HRQoL.

Methods

In the context of the longitudinal MAPA project, we included adult patients (≥ 18 years old) admitted with COVID-19 to the Intensive Care Medicine Department (ICMD) of a Portuguese University Hospital (October 2020-April 2021). Exclusion criteria were: ICMD length of stay ≤24h, terminal illness, major auditory loss, or inability to communicate at the time of assessment. Delirium during ICMD stay was ascertained based on patients’ clinical records. HRQoL was evaluated using the 5-Level EQ-5D questionnaire (EQ-5D-5L), at a scheduled telephone follow-up appointment on average 1-2 months after hospital discharge.

Results

Overall, 124 patients were included with a median age of 62 (range: 24-86) years, being mostly male (65%). About 19% had delirium, 42% were deeply sedated and 43% required invasive mechanical ventilation. Most survivors reported problems on the EQ-5D-5L domains: usual activities (85%), mobility (73%) and anxiety/depression (65%). Patients with delirium reported more pain/discomfort (75%vs46%; p=0.011) and considerably anxiety/depression (83%vs60%; p=0.032).

Conclusions

These findings pointed that COVID-19 patients who experienced delirium reported worse HRQoL, regarding pain/discomfort and anxiety/depression. This study highlights the importance of not only prevention but also early screening of delirium during hospital stay, as well as the crucial role of the timely interventions at discharge, in order to minimize delirium long-term impacts.

Disclosure

No significant relationships.

Keywords

Covid-19Quality-of-lifeCritical illnessdelirium
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S311
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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