The importance of early diagnosis in the elderly patients with Covid-19

Authors

DOI:

https://doi.org/10.33448/rsd-v11i10.33297

Keywords:

Coronavirus; Delirium; Elderly.

Abstract

Introduction: Delirium is a transient neuropsychiatric syndrome considered a geriatric emergency, related to prolonged periods of hospitalization and which contributes to an increase in the mortality rate, especially in the elderly affected by SARS-CoV-2. Objective: To carry out an integrative review of the literature in order to list factors of importance of screening, anamnesis and physical examination to contain the early manifestation of delirium in elderly patients affected by Covid-19. Methodology: This is an integrative literature review carried out by searching for scientific articles in Pubmed (NCBI), Latin American and Caribbean Health Sciences (Lilacs) and Scientific Electronic Library Online (SciELO) databases.). For this, the descriptors were used: Coronavirus, Delirium, Elderly and the filter “PUBLICATION DATE” was selected with the option “5 YEARS”, in the aforementioned databases. The articles selected through the PICO strategy were submitted to methodological rigor and level of evidence analysis. Results: 155 scientific articles were found; however, 17 articles were selected after analyzing the inclusion and exclusion criteria. Of this sample, 41, 17% of the selected studies reported that delirium is associated with high mortality and morbidity, in addition to being often underreported. Screening using tools such as the Chart-Based Delirium Identification Instrument is essential for early detection of delirium. Conclusion: Multiprofessional team work aligned with medical work is necessary for early intervention of delirium in elderly patients with Covid-19.

References

Alkeridy, W., Almaghlouth, I., Alrashed, R., Alayed,K., Binkhamis, K., Alsharidi, A., Liu-Ambrose, T. (2020). A Unique Presentation of Delirium in a Patient with Otherwise Asymptomatic Covid-19. Journal of the American Geriatrics Society, 68(7):1382-1384.

Benussi, A., Pilotto, A., Premi, E., Libri, I., Giunta, M., Agosti, C., Alberici, A., Baldelli, E., Benini, M., Bonacina, S., Beambilla, L., Caractozzolo, S., Cortinovis, M., Costa, A., Piccinelli, S. C., Cottini, E., Cristillho, V., Delrio, I., Gamba, M., Gazina, S., Gilberti, N., Imarisio, A., Invernizzi, P., Leggio, U., Liberini, P., Locatelli, M., Masciocchi, S., Rao, R., Risi, B., Rozzini, L., Scalvini, A., Spezia, R., Vergani, V., Volonghi, I., Borroni, B, Magoni, M., Pezzini, A., Padovani. (2020). Clinical characteristics and outcomes of inpatients with neurologic disease and Covid-19 in Brescia, Lombardy, Italy. Neurology, 95(7):910-920.

Bosco, E. B. D., Floriano, L. S. M., Skupien, S. V., Arcaro, G., Martins, A. R., Anselmo, A. C. C. (2020). A saúde mental da enfermagem no enfrentamento da Covid-19 em um hospital universitário regional. Revista Brasileira de Enfermagem, 73(1): e20200434..

Duggan, M. C., Van, J., Ely, E. W. (2021). Delirium Assessment in Critically Ill Older Adults: Considerations During the Covid-19 Pandemic. Critical care clinics, 37(1): 175–190.

Emmerton, D.; Abdelhafiz, A. (2020). Delirium in Older People with Covid-19: Clinical Scenario and Literature Review. SN Comprehensive Clinical Medicine, 2(1):1790 – 1797.

Forget, M. F., Del Degan, S., Leblanc, J., Tannous, R., Desjardins, M., Durand, M., Vu, T. T. M., Nguyen, Q. D., Desmarais, P. (2021). Delirium and Inflammation in Older Adults Hospitalized for Covid-19: A Cohort Study. Clinical interventions in aging, 16(1):1223-1230.

García-Grimshaw, M., Chiquete, E., Kimenez-Ruiz, A., Vidal-Mayo, J. J., Grajeda-Gonzalez, S. L., Vargas-Martinez, M. A., Toapanta-Yanchapaxi, L. N., Valdes-Ferrer, S., I., Chaves-Martinez, O. Al., Marche-Fernandes, O. A., Jimenez-Avila, A. I., Cantu-Brito, C., Flores-Silva, F.D. (2022). Delirium e fatores associados em uma coorte de pacientes hospitalizados com doença de coronavírus 2019. Journal of the Academy of Consultation-Liaison Psychiatry, 63(1):3-13.

Hariyanto, T. I., Putri, C., Hananto, J. E., Arisa, J., Situeang, R. F. V., Kurniawan, A. (2021). Delirium is a good predictor for poor outcomes from coronavirus disease 2019 (Covid-19) pneumonia: A systematic review, meta-analysis, and meta-regression. Journal of psychiatric research, 142(1):361-368.

Helms, J., Kremer, S., Merdji, H., Schenck, M., Severac, F., Clere-Jehl, R., Studer, A., Radosacljeic, M., Kummerlen, C., Monnier, A., Boular, C., Fafi-Kremer, S., Castelain, V., Ohana, M., Anheim, M., Schneider, F., Meziani, F. (2020). Delirium and encephalopathy in severe Covid-19: a cohort analysis of ICU patients. Critical care, 24(1):491.

Inouye, S. K. (2021). The Importance of Delirium and Delirium Prevention in Older Adults During Lockdowns. JAMA, 325(17):1779–1780.

Ito, C. M., Pedri, L. E. (2013). O uso da terapia farmacológica para a profilaxia do delirium: revisão sistemática. Revista Brasileira de Clinica Medica, 11(4):105.

Kennedy, M., Helfand, B. K. I., Gou, R. Y., Gartaganis, S. L., Webb, M., Moccia, J. M., Bruursema, S. N., Dokic, B., McCulloch, B., Ring, H., Margolin, J. D., Zhang, E., Anderson, R., Babine, R. L., Hshieh, T., Wong, A. H., Taylor, R. A., Davenport, K., Teresi, B., Fong, T. G., Inouye, S. K. (2020). Delirium in Older Patients with Covid-19 Presenting to the Emergency Department. JAMA network open, 3(11):e2029540.

Kotfis, K., Roberson, S. W., Wilson, J. E., Dabrowski, W., Pun, B. T., Eli, W. (2020). Covid-19-19: Manejo do delírio na UTI durante a pandemia de SARS-CoV-2. Crit Care, 24(176).

Lahue, S., Escueta, D. P., Guterman, E. L., Patel, K., Harrisoon, K. L., Boscardin, W. J., Douglas, V. C., Newman, J. C. (2022). Covid-19 severity and age increase the odds of delirium in hospitalized adults with confirmed SARS-CoV-2 infection: a cohort study. BMC psychiatry, 22:151.

Leslie, D. L. (2008). Custos de cuidados de saúde de um ano associados ao delirium na população idosa. Arquivos de medicina interna, 168(1):27-32.

Maldonado, J. (2017). Delirium pathophysiology: an updated hypothesis of the etiology of acute brain failure. International Journal of Geriatric Psychiatry, 33(4):1- 30.

Marengoni, A., Zucchelli, A., Grande, G., Fratiglioni, L., Rizzuto, D. (2020). The impact of delirium on outcomes for older adults hospitalized with Covid-19. Age and ageing, 49(1):923-926.

Martinotti, G., Bonanni, L., Barlati, S., Miuli, A., Sepede, G., Prestia, D., Trabucco, A., Palumbo, C., Massaro, A., Olcese, M., D’Ardes, D., Cipollone, F., Amore, M., Bondi, E., Russo, M., Carrarini, C., Onofrj, M., Sensi, S. L., Vita, A., Diannantonio, M. (2021). Delirium in Covid-19 patients: a multicentric observational study in Italy. Ciências Neurológicas: Jornal Oficial da Sociedade Italiana de Neurologia e da Sociedade Italiana de Neurofisiologia Clínica, 42(1):3981-3988.

Mattace-Raso, F., Polinder-Bos, H., Oosterwijk, B., Bruchem-Visser R., Goudzwaard, J., Oudshoorn, C., Ziere, G., Egberts, A. (2020). Delirium: A Frequent Manifestation in Covid-19 Older Patients. Clinical interventions in aging, 15(1): 2245-2247.

Mcloughlin, B. C., Miles, A., Webb, T. E., Knopp, P., Eyres, C., Fabbri, A., Humphries, F., Davis, D. (2020). Functional and cognitive outcomes after Covid-19 delirium. European geriatric medicine, 11(5): 857-862.

Mendes, A., Hermann, F. R., Francois, R., Perivier, S., Gold, G., Graf, C. E., Zekry, D. (2021). Delirium in Older Patients with Covid-19: Prevalence, Risk Factors, and Clinical Relevance. The journals of gerontology: Biological sciences and medical sciences, 76:e142-e146.

Moraes-Júnior, R. F., Costa, A. N., Maneschy, R. B., Pontes, C. D. N., Silva, Y. J. A., Holanda, L. S., Silva, L. S., Lima, L. G. S., Silva, A. F. T., Duarte, A. D. V., Mendes, D. M., Holanda, V. B. T. (2019). Principais fatores de risco para delirium encontrados nos pacientes idosos internados nas enfermarias de clínica médica de um hospital da Amazônia. Revista Eletrônica Acervo Saúde, 17(1):e272-e280.

Neto, P. D. F., Rosendo, C. W. F., Lima, F. A. S., Bezerra, Y. P. F., Nunes, V. M. A., Lima, S. P. S. (2021). O impacto da covid-19 na saúde de pessoas institucionalizadas. Revista Ciência Plural, 7(2): 196–210.

PHRU. Critical appraisal skills programme. Public Health Resource Unit, England, 2006. Disponível em: www.phru.nhs.uk.

Pranata, R., Huang, I., Lim, M. A., Yonas, E., Vania, R., Kuswardhani, R. A. T. (2021). Delirium and Mortality in Coronavirus Disease 2019 (Covid-19) - A Systematic Review and Meta-analysis. Archives of gerontology and geriatrics, 95:104388.

Shao, S., Chien-Cheng, L., Yi-Hung, C., Yung-Chang, C., Ming-Jui, H., Shu-Chen, L. (2021). Prevalence, incidence and mortality of delirium in patients with Covid-19: a systematic review and meta-analysis. Age and ageing, 50(5):1445-1453.

Soares, C. B., Hoga, L. A. K., Peduzzi, M., Sangaleti, C., Yonekura, T., Silva, D. R. A. D. (2006). Integrative review: Concepts and methods used in nursing. Revista da Escola de Enfermagem, 48(2):329:339.

Stillwell, S., Fineout-Overholt, E., Melnyk, B. M., Williamson, K.M. (2010). Evidence-Based Practice: Step by step. American Journal Nursing, 110(5):41-47.

Unicovsky, M. A. R.; Santarem, M. (2020). Desafios para enfermagem no atendimento aos pacientes idosos com delirium e Covid-19 em unidades de cuidados críticos. Enfermagem gerontológica no cuidado dos idosos em tempos da Covid-19, ed. 2, Brasília. (Série Enfermagem e Pandemias).

Zazzara, M. B., Penfold, R. S., Roberts, A. L., Lee, K. A., Sudre, C. D., Welch, C., Bowyer, R. C. E., Visconti, A., Mangino, M. (2021). Probable delirium is a presenting symptom of COVID-19 in frail, older adults: a cohort study of 322 hospitalized and 535 community-based older adults. Age and ageing, 50(1):40-48.

Published

10/08/2022

How to Cite

MAIA, E. K.; DOVIGI, P.; MACHADO, A. M.; ODA, J. Y. The importance of early diagnosis in the elderly patients with Covid-19. Research, Society and Development, [S. l.], v. 11, n. 10, p. e561111033297, 2022. DOI: 10.33448/rsd-v11i10.33297. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/33297. Acesso em: 19 apr. 2024.

Issue

Section

Health Sciences