COVID-19: What do we need to know about ICU delirium during the SARS-CoV-2 pandemic?
Identifieur interne : 000B07 ( Main/Exploration ); précédent : 000B06; suivant : 000B08COVID-19: What do we need to know about ICU delirium during the SARS-CoV-2 pandemic?
Auteurs : Katarzyna Kotfis [Pologne] ; Shawniqua Williams Roberson [États-Unis] ; Jo Wilson [États-Unis] ; Brenda Pun [États-Unis] ; E Wesley Ely [États-Unis] ; Ilona Je Owska [Royaume-Uni] ; Maja Jezierska [Pologne] ; Wojciech Dabrowski [Pologne]Source :
- Anaesthesiology intensive therapy [ 1731-2531 ] ; 2020.
Abstract
In March 2020, the World Health Organisation announced the COVID-19 pandemic caused by the SARS-CoV-2 virus. As well as respiratory failure, the SARS-CoV-2 may cause central nervous system (CNS) involvement, including delirium occurring in critically ill patients (ICU delirium). Due attention must be paid to this subject in the face of the COVID-19 pandemic. Delirium, the detection of which takes less than two minutes, is frequently underestimated during daily routine ICU care, but it may be a prodromal symptom of infection or hypoxia associated with severe respiratory failure. During the COVID-19 pandemic, systematic delirium monitoring using validated tests (CAM-ICU or ICDSC) may be sacrificed. This is likely to be due to the fact that the main emphasis is placed on organisational issues, i.e. the lack of ventilators, setting priorities for limited mechanical ventilation options, and a shortage of personal protective equipment. Early identification of patients with delirium is critical in patients with COVID-19 because the occurrence of delirium may be an early symptom of worsening respiratory failure or of infectious spread to the CNS mediated by potential neuroinvasive mechanisms of the coronavirus. The purpose of this review is to identify problems related to the development of delirium during the COVID-19 epidemic, which are presented in three areas: i) factors contributing to delirium in COVID-19, ii) potential pathophysiological factors of delirium in COVID-19, and iii) long-term consequences of delirium in COVID-19. This article discusses how healthcare workers can reduce the burden of delirium by identifying potential risk factors and difficulties during challenges associated with SARS-CoV-2 infection.
DOI: 10.5114/ait.2020.95164
PubMed: 32419438
Affiliations:
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Szczecin</wicri:regionArea><wicri:noRegion>Szczecin</wicri:noRegion></affiliation></author><author><name sortKey="Williams Roberson, Shawniqua" sort="Williams Roberson, Shawniqua" uniqKey="Williams Roberson S" first="Shawniqua" last="Williams Roberson">Shawniqua Williams Roberson</name><affiliation wicri:level="2"><nlm:affiliation>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Neurology, Vanderbilt University Medical Center, Nashville, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Department of Bioengineering, Vanderbilt University, Nashville, TN, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Bioengineering, Vanderbilt University, Nashville, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation></author><author><name sortKey="Wilson, Jo" sort="Wilson, Jo" uniqKey="Wilson J" first="Jo" last="Wilson">Jo Wilson</name><affiliation wicri:level="2"><nlm:affiliation>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Geriatric Research, Education, and Clinical Center (GRECC), Tennessee Valley Veterans Affairs Healthcare System, Nashville, TN, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Geriatric Research, Education, and Clinical Center (GRECC), Tennessee Valley Veterans Affairs Healthcare System, Nashville, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation></author><author><name sortKey="Pun, Brenda" sort="Pun, Brenda" uniqKey="Pun B" first="Brenda" last="Pun">Brenda Pun</name><affiliation wicri:level="2"><nlm:affiliation>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation></author><author><name sortKey="Ely, E Wesley" sort="Ely, E Wesley" uniqKey="Ely E" first="E Wesley" last="Ely">E Wesley Ely</name><affiliation wicri:level="2"><nlm:affiliation>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Geriatric Research, Education, and Clinical Center (GRECC), Tennessee Valley Veterans Affairs Healthcare System, Nashville, TN, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Geriatric Research, Education, and Clinical Center (GRECC), Tennessee Valley Veterans Affairs Healthcare System, Nashville, TN</wicri:regionArea><placeName><region type="state">Tennessee</region></placeName></affiliation><affiliation wicri:level="2"><nlm:affiliation>Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Tennessee</region></placeName><wicri:cityArea>Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville</wicri:cityArea></affiliation></author><author><name sortKey="Je Owska, Ilona" sort="Je Owska, Ilona" uniqKey="Je Owska I" first="Ilona" last="Je Owska">Ilona Je Owska</name><affiliation wicri:level="3"><nlm:affiliation>Integrative Counselling and Psychotherapy, The Minster Centre, Department of Psychology, Middlesex University, London, UK.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Integrative Counselling and Psychotherapy, The Minster Centre, Department of Psychology, Middlesex University, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Jezierska, Maja" sort="Jezierska, Maja" uniqKey="Jezierska M" first="Maja" last="Jezierska">Maja Jezierska</name><affiliation wicri:level="1"><nlm:affiliation>Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Poland.</nlm:affiliation><country xml:lang="fr">Pologne</country><wicri:regionArea>Department of Anaesthesiology and Intensive Care, Medical University of Lublin</wicri:regionArea><wicri:noRegion>Medical University of Lublin</wicri:noRegion></affiliation></author><author><name sortKey="Dabrowski, Wojciech" sort="Dabrowski, Wojciech" uniqKey="Dabrowski W" first="Wojciech" last="Dabrowski">Wojciech Dabrowski</name><affiliation wicri:level="1"><nlm:affiliation>Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Poland.</nlm:affiliation><country xml:lang="fr">Pologne</country><wicri:regionArea>Department of Anaesthesiology and Intensive Care, Medical University of Lublin</wicri:regionArea><wicri:noRegion>Medical University of Lublin</wicri:noRegion></affiliation></author></analytic><series><title level="j">Anaesthesiology intensive therapy</title><idno type="eISSN">1731-2531</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In March 2020, the World Health Organisation announced the COVID-19 pandemic caused by the SARS-CoV-2 virus. As well as respiratory failure, the SARS-CoV-2 may cause central nervous system (CNS) involvement, including delirium occurring in critically ill patients (ICU delirium). Due attention must be paid to this subject in the face of the COVID-19 pandemic. Delirium, the detection of which takes less than two minutes, is frequently underestimated during daily routine ICU care, but it may be a prodromal symptom of infection or hypoxia associated with severe respiratory failure. During the COVID-19 pandemic, systematic delirium monitoring using validated tests (CAM-ICU or ICDSC) may be sacrificed. This is likely to be due to the fact that the main emphasis is placed on organisational issues, i.e. the lack of ventilators, setting priorities for limited mechanical ventilation options, and a shortage of personal protective equipment. Early identification of patients with delirium is critical in patients with COVID-19 because the occurrence of delirium may be an early symptom of worsening respiratory failure or of infectious spread to the CNS mediated by potential neuroinvasive mechanisms of the coronavirus. The purpose of this review is to identify problems related to the development of delirium during the COVID-19 epidemic, which are presented in three areas: i) factors contributing to delirium in COVID-19, ii) potential pathophysiological factors of delirium in COVID-19, and iii) long-term consequences of delirium in COVID-19. This article discusses how healthcare workers can reduce the burden of delirium by identifying potential risk factors and difficulties during challenges associated with SARS-CoV-2 infection.</div></front></TEI><pubmed><MedlineCitation Status="In-Data-Review" Owner="NLM"><PMID Version="1">32419438</PMID><DateRevised><Year>2020</Year><Month>07</Month><Day>24</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1731-2531</ISSN><JournalIssue CitedMedium="Internet"><Volume>52</Volume><Issue>2</Issue><PubDate><Year>2020</Year></PubDate></JournalIssue><Title>Anaesthesiology intensive therapy</Title><ISOAbbreviation>Anaesthesiol Intensive Ther</ISOAbbreviation></Journal><ArticleTitle>COVID-19: What do we need to know about ICU delirium during the SARS-CoV-2 pandemic?</ArticleTitle><Pagination><MedlinePgn>132-138</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">40590</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.5114/ait.2020.95164</ELocationID><Abstract><AbstractText>In March 2020, the World Health Organisation announced the COVID-19 pandemic caused by the SARS-CoV-2 virus. As well as respiratory failure, the SARS-CoV-2 may cause central nervous system (CNS) involvement, including delirium occurring in critically ill patients (ICU delirium). Due attention must be paid to this subject in the face of the COVID-19 pandemic. Delirium, the detection of which takes less than two minutes, is frequently underestimated during daily routine ICU care, but it may be a prodromal symptom of infection or hypoxia associated with severe respiratory failure. During the COVID-19 pandemic, systematic delirium monitoring using validated tests (CAM-ICU or ICDSC) may be sacrificed. This is likely to be due to the fact that the main emphasis is placed on organisational issues, i.e. the lack of ventilators, setting priorities for limited mechanical ventilation options, and a shortage of personal protective equipment. Early identification of patients with delirium is critical in patients with COVID-19 because the occurrence of delirium may be an early symptom of worsening respiratory failure or of infectious spread to the CNS mediated by potential neuroinvasive mechanisms of the coronavirus. The purpose of this review is to identify problems related to the development of delirium during the COVID-19 epidemic, which are presented in three areas: i) factors contributing to delirium in COVID-19, ii) potential pathophysiological factors of delirium in COVID-19, and iii) long-term consequences of delirium in COVID-19. This article discusses how healthcare workers can reduce the burden of delirium by identifying potential risk factors and difficulties during challenges associated with SARS-CoV-2 infection.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Kotfis</LastName><ForeName>Katarzyna</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Anaesthesiology, Intensive Therapy, and Acute Intoxications, Pomeranian Medical University, Szczecin, Poland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Williams Roberson</LastName><ForeName>Shawniqua</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Bioengineering, Vanderbilt University, Nashville, TN, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wilson</LastName><ForeName>Jo</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Geriatric Research, Education, and Clinical Center (GRECC), Tennessee Valley Veterans Affairs Healthcare System, Nashville, TN, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Pun</LastName><ForeName>Brenda</ForeName><Initials>B</Initials><AffiliationInfo><Affiliation>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ely</LastName><ForeName>E Wesley</ForeName><Initials>EW</Initials><AffiliationInfo><Affiliation>Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Geriatric Research, Education, and Clinical Center (GRECC), Tennessee Valley Veterans Affairs Healthcare System, Nashville, TN, United States.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Division of Allergy, Pulmonary, and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, TN.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jeżowska</LastName><ForeName>Ilona</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Integrative Counselling and Psychotherapy, The Minster Centre, Department of Psychology, Middlesex University, London, UK.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Jezierska</LastName><ForeName>Maja</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Poland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dabrowski</LastName><ForeName>Wojciech</ForeName><Initials>W</Initials><AffiliationInfo><Affiliation>Department of Anaesthesiology and Intensive Care, Medical University of Lublin, Poland.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>Poland</Country><MedlineTA>Anaesthesiol Intensive Ther</MedlineTA><NlmUniqueID>101472620</NlmUniqueID><ISSNLinking>1642-5758</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N"> PICS</Keyword><Keyword MajorTopicYN="N"> PTSD</Keyword><Keyword MajorTopicYN="N"> SARS-CoV-2</Keyword><Keyword MajorTopicYN="N"> coronavirus</Keyword><Keyword MajorTopicYN="N"> delirium</Keyword><Keyword MajorTopicYN="N"> pain</Keyword><Keyword MajorTopicYN="N"> pandemic</Keyword><Keyword MajorTopicYN="N"> sedation</Keyword><Keyword MajorTopicYN="N">COVID-19</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>5</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>5</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>5</Month><Day>19</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32419438</ArticleId><ArticleId IdType="pii">40590</ArticleId><ArticleId IdType="doi">10.5114/ait.2020.95164</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>Pologne</li><li>Royaume-Uni</li><li>États-Unis</li></country><region><li>Angleterre</li><li>Grand Londres</li><li>Tennessee</li></region><settlement><li>Londres</li></settlement></list><tree><country name="Pologne"><noRegion><name sortKey="Kotfis, Katarzyna" sort="Kotfis, Katarzyna" uniqKey="Kotfis K" first="Katarzyna" last="Kotfis">Katarzyna Kotfis</name></noRegion><name sortKey="Dabrowski, Wojciech" sort="Dabrowski, Wojciech" uniqKey="Dabrowski W" first="Wojciech" last="Dabrowski">Wojciech Dabrowski</name><name sortKey="Jezierska, Maja" sort="Jezierska, Maja" uniqKey="Jezierska M" first="Maja" last="Jezierska">Maja Jezierska</name></country><country name="États-Unis"><region name="Tennessee"><name sortKey="Williams Roberson, Shawniqua" sort="Williams Roberson, Shawniqua" uniqKey="Williams Roberson S" first="Shawniqua" last="Williams Roberson">Shawniqua Williams Roberson</name></region><name sortKey="Ely, E Wesley" sort="Ely, E Wesley" uniqKey="Ely E" first="E Wesley" last="Ely">E Wesley Ely</name><name sortKey="Ely, E Wesley" sort="Ely, E Wesley" uniqKey="Ely E" first="E Wesley" last="Ely">E Wesley Ely</name><name sortKey="Ely, E Wesley" sort="Ely, E Wesley" uniqKey="Ely E" first="E Wesley" last="Ely">E Wesley Ely</name><name sortKey="Pun, Brenda" sort="Pun, Brenda" uniqKey="Pun B" first="Brenda" last="Pun">Brenda Pun</name><name sortKey="Williams Roberson, Shawniqua" sort="Williams Roberson, Shawniqua" uniqKey="Williams Roberson S" first="Shawniqua" last="Williams Roberson">Shawniqua Williams Roberson</name><name sortKey="Williams Roberson, Shawniqua" sort="Williams Roberson, Shawniqua" uniqKey="Williams Roberson S" first="Shawniqua" last="Williams Roberson">Shawniqua Williams Roberson</name><name sortKey="Wilson, Jo" sort="Wilson, Jo" uniqKey="Wilson J" first="Jo" last="Wilson">Jo Wilson</name><name sortKey="Wilson, Jo" sort="Wilson, Jo" uniqKey="Wilson J" first="Jo" last="Wilson">Jo Wilson</name><name sortKey="Wilson, Jo" sort="Wilson, Jo" uniqKey="Wilson J" first="Jo" last="Wilson">Jo Wilson</name></country><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Je Owska, Ilona" sort="Je Owska, Ilona" uniqKey="Je Owska I" first="Ilona" last="Je Owska">Ilona Je Owska</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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