Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patients.
Identifieur interne : 000681 ( Main/Exploration ); précédent : 000680; suivant : 000682Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patients.
Auteurs : Julie Helms [France] ; Stéphane Kremer [France] ; Hamid Merdji [France] ; Malika Schenck [France] ; François Severac [France] ; Raphaël Clere-Jehl [France] ; Antoine Studer [France] ; Mirjana Radosavljevic [France] ; Christine Kummerlen [France] ; Alexandra Monnier [France] ; Clotilde Boulay [France] ; Samira Fafi-Kremer [France] ; Vincent Castelain [France] ; Mickaël Ohana [France] ; Mathieu Anheim [France] ; Francis Schneider [France] ; Ferhat Meziani [France]Source :
- Critical care (London, England) [ 1466-609X ] ; 2020.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen (MeSH), Délire avec confusion (épidémiologie), Encéphalopathies (épidémiologie), Femelle (MeSH), Humains (MeSH), Indice de gravité de la maladie (MeSH), Infections à coronavirus (thérapie), Infections à coronavirus (épidémiologie), Mâle (MeSH), Pandémies (MeSH), Pneumopathie virale (thérapie), Pneumopathie virale (épidémiologie), Sujet âgé (MeSH), Unités de soins intensifs (MeSH), Études de cohortes (MeSH).
- MESH :
- thérapie : Infections à coronavirus, Pneumopathie virale.
- épidémiologie : Délire avec confusion, Encéphalopathies, Infections à coronavirus, Pneumopathie virale.
- Adulte d'âge moyen, Femelle, Humains, Indice de gravité de la maladie, Mâle, Pandémies, Sujet âgé, Unités de soins intensifs, Études de cohortes.
English descriptors
- KwdEn :
- Aged (MeSH), Brain Diseases (epidemiology), Cohort Studies (MeSH), Coronavirus Infections (epidemiology), Coronavirus Infections (therapy), Delirium (epidemiology), Female (MeSH), Humans (MeSH), Intensive Care Units (MeSH), Male (MeSH), Middle Aged (MeSH), Pandemics (MeSH), Pneumonia, Viral (epidemiology), Pneumonia, Viral (therapy), Severity of Illness Index (MeSH).
- MESH :
- epidemiology : Brain Diseases, Coronavirus Infections, Delirium, Pneumonia, Viral.
- therapy : Coronavirus Infections, Pneumonia, Viral.
- Aged, Cohort Studies, Female, Humans, Intensive Care Units, Male, Middle Aged, Pandemics, Severity of Illness Index.
Abstract
BACKGROUND
Neurotropism of SARS-CoV-2 and its neurological manifestations have now been confirmed. We aimed at describing delirium and neurological symptoms of COVID-19 in ICU patients.
METHODS
We conducted a bicentric cohort study in two French ICUs of Strasbourg University Hospital. All the 150 patients referred for acute respiratory distress syndrome due to SARS-CoV-2 between March 3 and May 5, 2020, were included at their admission. Ten patients (6.7%) were excluded because they remained under neuromuscular blockers during their entire ICU stay. Neurological examination, including CAM-ICU, and cerebrospinal fluid analysis, electroencephalography, and magnetic resonance imaging (MRI) were performed in some of the patients with delirium and/or abnormal neurological examination. The primary endpoint was to describe the incidence of delirium and/or abnormal neurological examination. The secondary endpoints were to describe the characteristics of delirium, to compare the duration of invasive mechanical ventilation and ICU length of stay in patients with and without delirium and/or abnormal neurological symptoms.
RESULTS
The 140 patients were aged in median of 62 [IQR 52; 70] years old, with a median SAPSII of 49 [IQR 37; 64] points. Neurological examination was normal in 22 patients (15.7%). One hundred eighteen patients (84.3%) developed a delirium with a combination of acute attention, awareness, and cognition disturbances. Eighty-eight patients (69.3%) presented an unexpected state of agitation despite high infusion rates of sedative treatments and neuroleptics, and 89 (63.6%) patients had corticospinal tract signs. Brain MRI performed in 28 patients demonstrated enhancement of subarachnoid spaces in 17/28 patients (60.7%), intraparenchymal, predominantly white matter abnormalities in 8 patients, and perfusion abnormalities in 17/26 patients (65.4%). The 42 electroencephalograms mostly revealed unspecific abnormalities or diffuse, especially bifrontal, slow activity. Cerebrospinal fluid examination revealed inflammatory disturbances in 18/28 patients, including oligoclonal bands with mirror pattern and elevated IL-6. The CSF RT-PCR SARS-CoV-2 was positive in one patient. The delirium/neurological symptoms in COVID-19 patients were responsible for longer mechanical ventilation compared to the patients without delirium/neurological symptoms. Delirium/neurological symptoms could be secondary to systemic inflammatory reaction to SARS-CoV-2.
CONCLUSIONS AND RELEVANCE
Delirium/neurological symptoms in COVID-19 patients are a major issue in ICUs, especially in the context of insufficient human and material resources.
TRIAL REGISTRATION
NA.
DOI: 10.1186/s13054-020-03200-1
PubMed: 32771053
PubMed Central: PMC7414289
Affiliations:
Links toward previous steps (curation, corpus...)
Le document en format XML
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last="Kummerlen">Christine Kummerlen</name><affiliation wicri:level="1"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex</wicri:regionArea><wicri:noRegion>Cedex</wicri:noRegion><wicri:noRegion>Cedex</wicri:noRegion></affiliation></author><author><name sortKey="Monnier, Alexandra" sort="Monnier, Alexandra" uniqKey="Monnier A" first="Alexandra" last="Monnier">Alexandra Monnier</name><affiliation wicri:level="1"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex</wicri:regionArea><wicri:noRegion>Cedex</wicri:noRegion><wicri:noRegion>Cedex</wicri:noRegion></affiliation></author><author><name sortKey="Boulay, Clotilde" sort="Boulay, Clotilde" uniqKey="Boulay C" first="Clotilde" last="Boulay">Clotilde Boulay</name><affiliation wicri:level="3"><nlm:affiliation>Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch</wicri:regionArea><wicri:noRegion>Illkirch</wicri:noRegion><orgName type="university">Université de Strasbourg</orgName><placeName><settlement type="city">Strasbourg</settlement><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Alsace (région administrative)</region></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName><orgName type="university">Université de Strasbourg</orgName></affiliation></author><author><name sortKey="Fafi Kremer, Samira" sort="Fafi Kremer, Samira" uniqKey="Fafi Kremer S" first="Samira" last="Fafi-Kremer">Samira Fafi-Kremer</name><affiliation wicri:level="3"><nlm:affiliation>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Laboratoire de Virologie Médicale, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Laboratoire de Virologie Médicale, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Castelain, Vincent" sort="Castelain, Vincent" uniqKey="Castelain V" first="Vincent" last="Castelain">Vincent Castelain</name><affiliation wicri:level="3"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Ohana, Mickael" sort="Ohana, Mickael" uniqKey="Ohana M" first="Mickaël" last="Ohana">Mickaël Ohana</name><affiliation wicri:level="3"><nlm:affiliation>Radiology Department, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Radiology Department, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Anheim, Mathieu" sort="Anheim, Mathieu" uniqKey="Anheim M" first="Mathieu" last="Anheim">Mathieu Anheim</name><affiliation wicri:level="3"><nlm:affiliation>Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch</wicri:regionArea><wicri:noRegion>Illkirch</wicri:noRegion><orgName type="university">Université de Strasbourg</orgName><placeName><settlement type="city">Strasbourg</settlement><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Alsace (région administrative)</region></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName><orgName type="university">Université de Strasbourg</orgName></affiliation></author><author><name sortKey="Schneider, Francis" sort="Schneider, Francis" uniqKey="Schneider F" first="Francis" last="Schneider">Francis Schneider</name><affiliation wicri:level="3"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Meziani, Ferhat" sort="Meziani, Ferhat" uniqKey="Meziani F" first="Ferhat" last="Meziani">Ferhat Meziani</name><affiliation wicri:level="1"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France. ferhat.meziani@chru-strasbourg.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex</wicri:regionArea><wicri:noRegion>Cedex</wicri:noRegion><wicri:noRegion>Cedex</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France. ferhat.meziani@chru-strasbourg.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32771053</idno><idno type="pmid">32771053</idno><idno type="doi">10.1186/s13054-020-03200-1</idno><idno type="pmc">PMC7414289</idno><idno type="wicri:Area/Main/Corpus">000740</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000740</idno><idno type="wicri:Area/Main/Curation">000740</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Curation">000740</idno><idno type="wicri:Area/Main/Exploration">000740</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patients.</title><author><name sortKey="Helms, Julie" sort="Helms, Julie" uniqKey="Helms J" first="Julie" last="Helms">Julie Helms</name><affiliation wicri:level="1"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex</wicri:regionArea><wicri:noRegion>Cedex</wicri:noRegion><wicri:noRegion>Cedex</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Kremer, Stephane" sort="Kremer, Stephane" uniqKey="Kremer S" first="Stéphane" last="Kremer">Stéphane Kremer</name><affiliation wicri:level="3"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service d'imagerie 2, Hôpital de Hautepierre, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service d'imagerie 2, Hôpital de Hautepierre, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Merdji, Hamid" sort="Merdji, Hamid" uniqKey="Merdji H" first="Hamid" last="Merdji">Hamid Merdji</name><affiliation wicri:level="1"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex</wicri:regionArea><wicri:noRegion>Cedex</wicri:noRegion><wicri:noRegion>Cedex</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Schenck, Malika" sort="Schenck, Malika" uniqKey="Schenck M" first="Malika" last="Schenck">Malika Schenck</name><affiliation wicri:level="3"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Severac, Francois" sort="Severac, Francois" uniqKey="Severac F" first="François" last="Severac">François Severac</name><affiliation wicri:level="3"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Groupe Méthodes en Recherche Clinique (GMRC), Hôpital Civil, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Groupe Méthodes en Recherche Clinique (GMRC), Hôpital Civil, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Clere Jehl, Raphael" sort="Clere Jehl, Raphael" uniqKey="Clere Jehl R" first="Raphaël" last="Clere-Jehl">Raphaël Clere-Jehl</name><affiliation wicri:level="1"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex</wicri:regionArea><wicri:noRegion>Cedex</wicri:noRegion><wicri:noRegion>Cedex</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Studer, Antoine" sort="Studer, Antoine" uniqKey="Studer A" first="Antoine" last="Studer">Antoine Studer</name><affiliation wicri:level="1"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex</wicri:regionArea><wicri:noRegion>Cedex</wicri:noRegion><wicri:noRegion>Cedex</wicri:noRegion></affiliation></author><author><name sortKey="Radosavljevic, Mirjana" sort="Radosavljevic, Mirjana" uniqKey="Radosavljevic M" first="Mirjana" last="Radosavljevic">Mirjana Radosavljevic</name><affiliation wicri:level="3"><nlm:affiliation>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Laboratoire d'immunologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Laboratoire d'immunologie, Hôpitaux Universitaires de Strasbourg, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Kummerlen, Christine" sort="Kummerlen, Christine" uniqKey="Kummerlen C" first="Christine" last="Kummerlen">Christine Kummerlen</name><affiliation wicri:level="1"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex</wicri:regionArea><wicri:noRegion>Cedex</wicri:noRegion><wicri:noRegion>Cedex</wicri:noRegion></affiliation></author><author><name sortKey="Monnier, Alexandra" sort="Monnier, Alexandra" uniqKey="Monnier A" first="Alexandra" last="Monnier">Alexandra Monnier</name><affiliation wicri:level="1"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex</wicri:regionArea><wicri:noRegion>Cedex</wicri:noRegion><wicri:noRegion>Cedex</wicri:noRegion></affiliation></author><author><name sortKey="Boulay, Clotilde" sort="Boulay, Clotilde" uniqKey="Boulay C" first="Clotilde" last="Boulay">Clotilde Boulay</name><affiliation wicri:level="3"><nlm:affiliation>Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch</wicri:regionArea><wicri:noRegion>Illkirch</wicri:noRegion><orgName type="university">Université de Strasbourg</orgName><placeName><settlement type="city">Strasbourg</settlement><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Alsace (région administrative)</region></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName><orgName type="university">Université de Strasbourg</orgName></affiliation></author><author><name sortKey="Fafi Kremer, Samira" sort="Fafi Kremer, Samira" uniqKey="Fafi Kremer S" first="Samira" last="Fafi-Kremer">Samira Fafi-Kremer</name><affiliation wicri:level="3"><nlm:affiliation>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation><affiliation wicri:level="3"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Laboratoire de Virologie Médicale, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Laboratoire de Virologie Médicale, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Castelain, Vincent" sort="Castelain, Vincent" uniqKey="Castelain V" first="Vincent" last="Castelain">Vincent Castelain</name><affiliation wicri:level="3"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Ohana, Mickael" sort="Ohana, Mickael" uniqKey="Ohana M" first="Mickaël" last="Ohana">Mickaël Ohana</name><affiliation wicri:level="3"><nlm:affiliation>Radiology Department, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Radiology Department, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Anheim, Mathieu" sort="Anheim, Mathieu" uniqKey="Anheim M" first="Mathieu" last="Anheim">Mathieu Anheim</name><affiliation wicri:level="3"><nlm:affiliation>Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch</wicri:regionArea><wicri:noRegion>Illkirch</wicri:noRegion><orgName type="university">Université de Strasbourg</orgName><placeName><settlement type="city">Strasbourg</settlement><region type="region" nuts="2">Grand Est</region><region type="old region" nuts="2">Alsace (région administrative)</region></placeName></affiliation><affiliation wicri:level="4"><nlm:affiliation>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName><orgName type="university">Université de Strasbourg</orgName></affiliation></author><author><name sortKey="Schneider, Francis" sort="Schneider, Francis" uniqKey="Schneider F" first="Francis" last="Schneider">Francis Schneider</name><affiliation wicri:level="3"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author><author><name sortKey="Meziani, Ferhat" sort="Meziani, Ferhat" uniqKey="Meziani F" first="Ferhat" last="Meziani">Ferhat Meziani</name><affiliation wicri:level="1"><nlm:affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France. ferhat.meziani@chru-strasbourg.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex</wicri:regionArea><wicri:noRegion>Cedex</wicri:noRegion><wicri:noRegion>Cedex</wicri:noRegion></affiliation><affiliation wicri:level="3"><nlm:affiliation>INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France. ferhat.meziani@chru-strasbourg.fr.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg</wicri:regionArea><placeName><region type="region">Grand Est</region><region type="old region">Alsace (région administrative)</region><settlement type="city">Strasbourg</settlement></placeName></affiliation></author></analytic><series><title level="j">Critical care (London, England)</title><idno type="eISSN">1466-609X</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Brain Diseases (epidemiology)</term><term>Cohort Studies (MeSH)</term><term>Coronavirus Infections (epidemiology)</term><term>Coronavirus Infections (therapy)</term><term>Delirium (epidemiology)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Intensive Care Units (MeSH)</term><term>Male (MeSH)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (epidemiology)</term><term>Pneumonia, Viral (therapy)</term><term>Severity of Illness Index (MeSH)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen (MeSH)</term><term>Délire avec confusion (épidémiologie)</term><term>Encéphalopathies (épidémiologie)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Indice de gravité de la maladie (MeSH)</term><term>Infections à coronavirus (thérapie)</term><term>Infections à coronavirus (épidémiologie)</term><term>Mâle (MeSH)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (thérapie)</term><term>Pneumopathie virale (épidémiologie)</term><term>Sujet âgé (MeSH)</term><term>Unités de soins intensifs (MeSH)</term><term>Études de cohortes (MeSH)</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Brain Diseases</term><term>Coronavirus Infections</term><term>Delirium</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="thérapie" xml:lang="fr"><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Délire avec confusion</term><term>Encéphalopathies</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Cohort Studies</term><term>Female</term><term>Humans</term><term>Intensive Care Units</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Severity of Illness Index</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Femelle</term><term>Humains</term><term>Indice de gravité de la maladie</term><term>Mâle</term><term>Pandémies</term><term>Sujet âgé</term><term>Unités de soins intensifs</term><term>Études de cohortes</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>Neurotropism of SARS-CoV-2 and its neurological manifestations have now been confirmed. We aimed at describing delirium and neurological symptoms of COVID-19 in ICU patients.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>We conducted a bicentric cohort study in two French ICUs of Strasbourg University Hospital. All the 150 patients referred for acute respiratory distress syndrome due to SARS-CoV-2 between March 3 and May 5, 2020, were included at their admission. Ten patients (6.7%) were excluded because they remained under neuromuscular blockers during their entire ICU stay. Neurological examination, including CAM-ICU, and cerebrospinal fluid analysis, electroencephalography, and magnetic resonance imaging (MRI) were performed in some of the patients with delirium and/or abnormal neurological examination. The primary endpoint was to describe the incidence of delirium and/or abnormal neurological examination. The secondary endpoints were to describe the characteristics of delirium, to compare the duration of invasive mechanical ventilation and ICU length of stay in patients with and without delirium and/or abnormal neurological symptoms.</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>The 140 patients were aged in median of 62 [IQR 52; 70] years old, with a median SAPSII of 49 [IQR 37; 64] points. Neurological examination was normal in 22 patients (15.7%). One hundred eighteen patients (84.3%) developed a delirium with a combination of acute attention, awareness, and cognition disturbances. Eighty-eight patients (69.3%) presented an unexpected state of agitation despite high infusion rates of sedative treatments and neuroleptics, and 89 (63.6%) patients had corticospinal tract signs. Brain MRI performed in 28 patients demonstrated enhancement of subarachnoid spaces in 17/28 patients (60.7%), intraparenchymal, predominantly white matter abnormalities in 8 patients, and perfusion abnormalities in 17/26 patients (65.4%). The 42 electroencephalograms mostly revealed unspecific abnormalities or diffuse, especially bifrontal, slow activity. Cerebrospinal fluid examination revealed inflammatory disturbances in 18/28 patients, including oligoclonal bands with mirror pattern and elevated IL-6. The CSF RT-PCR SARS-CoV-2 was positive in one patient. The delirium/neurological symptoms in COVID-19 patients were responsible for longer mechanical ventilation compared to the patients without delirium/neurological symptoms. Delirium/neurological symptoms could be secondary to systemic inflammatory reaction to SARS-CoV-2.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSIONS AND RELEVANCE</b></p><p>Delirium/neurological symptoms in COVID-19 patients are a major issue in ICUs, especially in the context of insufficient human and material resources.</p></div><div type="abstract" xml:lang="en"><p><b>TRIAL REGISTRATION</b></p><p>NA.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32771053</PMID><DateCompleted><Year>2020</Year><Month>08</Month><Day>11</Day></DateCompleted><DateRevised><Year>2020</Year><Month>08</Month><Day>14</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1466-609X</ISSN><JournalIssue CitedMedium="Internet"><Volume>24</Volume><Issue>1</Issue><PubDate><Year>2020</Year><Month>08</Month><Day>08</Day></PubDate></JournalIssue><Title>Critical care (London, England)</Title><ISOAbbreviation>Crit Care</ISOAbbreviation></Journal><ArticleTitle>Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patients.</ArticleTitle><Pagination><MedlinePgn>491</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s13054-020-03200-1</ELocationID><Abstract><AbstractText Label="BACKGROUND">Neurotropism of SARS-CoV-2 and its neurological manifestations have now been confirmed. We aimed at describing delirium and neurological symptoms of COVID-19 in ICU patients.</AbstractText><AbstractText Label="METHODS">We conducted a bicentric cohort study in two French ICUs of Strasbourg University Hospital. All the 150 patients referred for acute respiratory distress syndrome due to SARS-CoV-2 between March 3 and May 5, 2020, were included at their admission. Ten patients (6.7%) were excluded because they remained under neuromuscular blockers during their entire ICU stay. Neurological examination, including CAM-ICU, and cerebrospinal fluid analysis, electroencephalography, and magnetic resonance imaging (MRI) were performed in some of the patients with delirium and/or abnormal neurological examination. The primary endpoint was to describe the incidence of delirium and/or abnormal neurological examination. The secondary endpoints were to describe the characteristics of delirium, to compare the duration of invasive mechanical ventilation and ICU length of stay in patients with and without delirium and/or abnormal neurological symptoms.</AbstractText><AbstractText Label="RESULTS">The 140 patients were aged in median of 62 [IQR 52; 70] years old, with a median SAPSII of 49 [IQR 37; 64] points. Neurological examination was normal in 22 patients (15.7%). One hundred eighteen patients (84.3%) developed a delirium with a combination of acute attention, awareness, and cognition disturbances. Eighty-eight patients (69.3%) presented an unexpected state of agitation despite high infusion rates of sedative treatments and neuroleptics, and 89 (63.6%) patients had corticospinal tract signs. Brain MRI performed in 28 patients demonstrated enhancement of subarachnoid spaces in 17/28 patients (60.7%), intraparenchymal, predominantly white matter abnormalities in 8 patients, and perfusion abnormalities in 17/26 patients (65.4%). The 42 electroencephalograms mostly revealed unspecific abnormalities or diffuse, especially bifrontal, slow activity. Cerebrospinal fluid examination revealed inflammatory disturbances in 18/28 patients, including oligoclonal bands with mirror pattern and elevated IL-6. The CSF RT-PCR SARS-CoV-2 was positive in one patient. The delirium/neurological symptoms in COVID-19 patients were responsible for longer mechanical ventilation compared to the patients without delirium/neurological symptoms. Delirium/neurological symptoms could be secondary to systemic inflammatory reaction to SARS-CoV-2.</AbstractText><AbstractText Label="CONCLUSIONS AND RELEVANCE">Delirium/neurological symptoms in COVID-19 patients are a major issue in ICUs, especially in the context of insufficient human and material resources.</AbstractText><AbstractText Label="TRIAL REGISTRATION">NA.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Helms</LastName><ForeName>Julie</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kremer</LastName><ForeName>Stéphane</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Service d'imagerie 2, Hôpital de Hautepierre, Strasbourg, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Engineering Science, Computer Science and Imaging Laboratory (ICube), Integrative Multimodal Imaging in Healthcare, UMR 7357, University of Strasbourg-CNRS, Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Merdji</LastName><ForeName>Hamid</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schenck</LastName><ForeName>Malika</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Severac</LastName><ForeName>François</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Groupe Méthodes en Recherche Clinique (GMRC), Hôpital Civil, Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Clere-Jehl</LastName><ForeName>Raphaël</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Studer</LastName><ForeName>Antoine</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Radosavljevic</LastName><ForeName>Mirjana</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Laboratoire d'immunologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kummerlen</LastName><ForeName>Christine</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Monnier</LastName><ForeName>Alexandra</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boulay</LastName><ForeName>Clotilde</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Fafi-Kremer</LastName><ForeName>Samira</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>ImmunoRhumatologie Moléculaire, INSERM UMR_S1109, LabEx TRANSPLANTEX, Centre de Recherche d'Immunologie et d'Hématologie, Faculté de Médecine, Fédération Hospitalo-Universitaire (FHU) OMICARE, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Strasbourg, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Laboratoire de Virologie Médicale, Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Castelain</LastName><ForeName>Vincent</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ohana</LastName><ForeName>Mickaël</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Radiology Department, Nouvel Hôpital Civil, Strasbourg University Hospital, Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Anheim</LastName><ForeName>Mathieu</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Service de Neurologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), INSERM-U964/CNRS-UMR7104/Université de Strasbourg, Illkirch, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg, Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schneider</LastName><ForeName>Francis</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Hautepierre, Strasbourg, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Meziani</LastName><ForeName>Ferhat</ForeName><Initials>F</Initials><Identifier Source="ORCID">0000-0002-1005-9095</Identifier><AffiliationInfo><Affiliation>Hôpitaux Universitaires de Strasbourg, Service de Médecine Intensive-Réanimation, Nouvel Hôpital Civil, 1, place de l'Hôpital, F-67091, Strasbourg, Cedex, France. ferhat.meziani@chru-strasbourg.fr.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine (RNM), FMTS, Strasbourg, France. ferhat.meziani@chru-strasbourg.fr.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>08</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>Crit Care</MedlineTA><NlmUniqueID>9801902</NlmUniqueID><ISSNLinking>1364-8535</ISSNLinking></MedlineJournalInfo><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001927" MajorTopicYN="N">Brain Diseases</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D015331" MajorTopicYN="N">Cohort Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D003693" MajorTopicYN="N">Delirium</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007362" MajorTopicYN="N">Intensive Care Units</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000628" MajorTopicYN="Y">therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012720" MajorTopicYN="N">Severity of Illness Index</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">COVID-19</Keyword><Keyword MajorTopicYN="Y">Delirium</Keyword><Keyword MajorTopicYN="Y">Encephalopathy</Keyword><Keyword MajorTopicYN="Y">ICU</Keyword><Keyword MajorTopicYN="Y">MRI</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>07</Month><Day>26</Day></PubMedPubDate><PubMedPubDate 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administrative)</li><li>Grand Est</li></region><settlement><li>Strasbourg</li></settlement><orgName><li>Université de Strasbourg</li></orgName></list><tree><country name="France"><noRegion><name sortKey="Helms, Julie" sort="Helms, Julie" uniqKey="Helms J" first="Julie" last="Helms">Julie Helms</name></noRegion><name sortKey="Anheim, Mathieu" sort="Anheim, Mathieu" uniqKey="Anheim M" first="Mathieu" last="Anheim">Mathieu Anheim</name><name sortKey="Anheim, Mathieu" sort="Anheim, Mathieu" uniqKey="Anheim M" first="Mathieu" last="Anheim">Mathieu Anheim</name><name sortKey="Anheim, Mathieu" sort="Anheim, Mathieu" uniqKey="Anheim M" first="Mathieu" last="Anheim">Mathieu Anheim</name><name sortKey="Boulay, Clotilde" sort="Boulay, Clotilde" uniqKey="Boulay C" first="Clotilde" last="Boulay">Clotilde Boulay</name><name sortKey="Boulay, Clotilde" sort="Boulay, Clotilde" uniqKey="Boulay C" first="Clotilde" last="Boulay">Clotilde Boulay</name><name sortKey="Boulay, Clotilde" sort="Boulay, Clotilde" uniqKey="Boulay C" first="Clotilde" last="Boulay">Clotilde Boulay</name><name sortKey="Castelain, Vincent" sort="Castelain, Vincent" uniqKey="Castelain V" first="Vincent" last="Castelain">Vincent Castelain</name><name sortKey="Clere Jehl, Raphael" sort="Clere Jehl, Raphael" uniqKey="Clere Jehl R" first="Raphaël" last="Clere-Jehl">Raphaël Clere-Jehl</name><name sortKey="Clere Jehl, Raphael" sort="Clere Jehl, Raphael" uniqKey="Clere Jehl R" first="Raphaël" last="Clere-Jehl">Raphaël Clere-Jehl</name><name sortKey="Fafi Kremer, Samira" sort="Fafi Kremer, Samira" uniqKey="Fafi Kremer S" first="Samira" last="Fafi-Kremer">Samira Fafi-Kremer</name><name sortKey="Fafi Kremer, Samira" sort="Fafi Kremer, Samira" uniqKey="Fafi Kremer S" first="Samira" last="Fafi-Kremer">Samira Fafi-Kremer</name><name sortKey="Helms, Julie" sort="Helms, Julie" uniqKey="Helms J" first="Julie" last="Helms">Julie Helms</name><name sortKey="Kremer, Stephane" sort="Kremer, Stephane" uniqKey="Kremer S" first="Stéphane" last="Kremer">Stéphane Kremer</name><name sortKey="Kremer, Stephane" sort="Kremer, Stephane" uniqKey="Kremer S" first="Stéphane" last="Kremer">Stéphane Kremer</name><name sortKey="Kummerlen, Christine" sort="Kummerlen, Christine" uniqKey="Kummerlen C" first="Christine" last="Kummerlen">Christine Kummerlen</name><name sortKey="Merdji, Hamid" sort="Merdji, Hamid" uniqKey="Merdji H" first="Hamid" last="Merdji">Hamid Merdji</name><name sortKey="Merdji, Hamid" sort="Merdji, Hamid" uniqKey="Merdji H" first="Hamid" last="Merdji">Hamid Merdji</name><name sortKey="Meziani, Ferhat" sort="Meziani, Ferhat" uniqKey="Meziani F" first="Ferhat" last="Meziani">Ferhat Meziani</name><name sortKey="Meziani, Ferhat" sort="Meziani, Ferhat" uniqKey="Meziani F" first="Ferhat" last="Meziani">Ferhat Meziani</name><name sortKey="Monnier, Alexandra" sort="Monnier, Alexandra" uniqKey="Monnier A" first="Alexandra" last="Monnier">Alexandra Monnier</name><name sortKey="Ohana, Mickael" sort="Ohana, Mickael" uniqKey="Ohana M" first="Mickaël" last="Ohana">Mickaël Ohana</name><name sortKey="Radosavljevic, Mirjana" sort="Radosavljevic, Mirjana" uniqKey="Radosavljevic M" first="Mirjana" last="Radosavljevic">Mirjana Radosavljevic</name><name sortKey="Radosavljevic, Mirjana" sort="Radosavljevic, Mirjana" uniqKey="Radosavljevic M" first="Mirjana" last="Radosavljevic">Mirjana Radosavljevic</name><name sortKey="Schenck, Malika" sort="Schenck, Malika" uniqKey="Schenck M" first="Malika" last="Schenck">Malika Schenck</name><name sortKey="Schneider, Francis" sort="Schneider, Francis" uniqKey="Schneider F" first="Francis" last="Schneider">Francis Schneider</name><name sortKey="Severac, Francois" sort="Severac, Francois" uniqKey="Severac F" first="François" last="Severac">François Severac</name><name sortKey="Studer, Antoine" sort="Studer, Antoine" uniqKey="Studer A" first="Antoine" last="Studer">Antoine Studer</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix 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|wiki= Sante
|area= CovidSeniorV1
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|clé= pubmed:32771053
|texte= Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patients.
}}
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