Purpose: Delirium has been recognized as an atypical presenting feature of COVID-19 in older adults and is independently associated with mortality. We aimed to perform an updated systematic review of the literature and proportional meta-analysis to assess prevalence and incidence of delirium in older adults with COVID-19, addressing differences according to sex, frailty status, and settings. Methods: We searched databases for English-language articles on prevalence and incidence of delirium in older adults with COVID-19, published between March 2020 and January 2023. Results: Of the 1171 articles identified, 66 met selection criteria and were included in the meta-analysis (n = 35,035 participants, age-range 66–90 years old, 46.6% females). We observed similar pooled prevalence (20.6% [95% Confidence Interval (CI) 17.8–23.8%]) and incidence (21.3% [95% CI 14.7–30%]) of delirium. Pooled occurrence (both prevalence and incidence) of delirium was similar according to sex (females 21.3% [95% CI 16–27.5%] vs. males 23.8%% [95% CI 18.2–30.4%], p-value = 0.55) and study setting (nursing homes 22.5% [95% CI 14.2–33.6%] vs. hospital 20.3% [95% CI 17–24%], p = 0.68), but it was significantly higher in frail versus non-frail patients (37% [95% CI 26.6–48.8%] vs. 12.5% [95% CI 7.8–19.6%], p-value < 0.01). Delirium definitions and assessment tools largely varied across studies. Conclusion: This review delineates delirium as a common feature of COVID-19, particularly in frail older adults, and supports its formal inclusion among COVID-19 symptoms. The considerable heterogeneity in delirium assessment highlights the need for an operational strategy to standardize definitions and tools utilization in the management of frail older adults.

Zazzara, M., Ornago, A., Cocchi, C., Serafini, E., Bellelli, G., Onder, G. (2024). A pandemic of delirium: an updated systematic review and meta-analysis of occurrence of delirium in older adults with COVID-19. EUROPEAN GERIATRIC MEDICINE, 15(2), 397-406 [10.1007/s41999-023-00906-7].

A pandemic of delirium: an updated systematic review and meta-analysis of occurrence of delirium in older adults with COVID-19

Ornago, AM
Secondo
;
Bellelli, G
Penultimo
;
2024

Abstract

Purpose: Delirium has been recognized as an atypical presenting feature of COVID-19 in older adults and is independently associated with mortality. We aimed to perform an updated systematic review of the literature and proportional meta-analysis to assess prevalence and incidence of delirium in older adults with COVID-19, addressing differences according to sex, frailty status, and settings. Methods: We searched databases for English-language articles on prevalence and incidence of delirium in older adults with COVID-19, published between March 2020 and January 2023. Results: Of the 1171 articles identified, 66 met selection criteria and were included in the meta-analysis (n = 35,035 participants, age-range 66–90 years old, 46.6% females). We observed similar pooled prevalence (20.6% [95% Confidence Interval (CI) 17.8–23.8%]) and incidence (21.3% [95% CI 14.7–30%]) of delirium. Pooled occurrence (both prevalence and incidence) of delirium was similar according to sex (females 21.3% [95% CI 16–27.5%] vs. males 23.8%% [95% CI 18.2–30.4%], p-value = 0.55) and study setting (nursing homes 22.5% [95% CI 14.2–33.6%] vs. hospital 20.3% [95% CI 17–24%], p = 0.68), but it was significantly higher in frail versus non-frail patients (37% [95% CI 26.6–48.8%] vs. 12.5% [95% CI 7.8–19.6%], p-value < 0.01). Delirium definitions and assessment tools largely varied across studies. Conclusion: This review delineates delirium as a common feature of COVID-19, particularly in frail older adults, and supports its formal inclusion among COVID-19 symptoms. The considerable heterogeneity in delirium assessment highlights the need for an operational strategy to standardize definitions and tools utilization in the management of frail older adults.
Articolo in rivista - Articolo scientifico
COVID-19; Delirium; Frailty; Older adults; SARS-CoV-2 infection;
English
18-mar-2024
2024
15
2
397
406
none
Zazzara, M., Ornago, A., Cocchi, C., Serafini, E., Bellelli, G., Onder, G. (2024). A pandemic of delirium: an updated systematic review and meta-analysis of occurrence of delirium in older adults with COVID-19. EUROPEAN GERIATRIC MEDICINE, 15(2), 397-406 [10.1007/s41999-023-00906-7].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/467858
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