About: Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patients

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An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patients
Creator	Fafi-Kremer, Samira Schneider, Francis Anheim, Mathieu Boulay, Clotilde Castelain, Vincent Clere-Jehl, Raphaël Helms, Julie Kremer, Stéphane Merdji, Hamid Meziani, Ferhat Monnier, Alexandra Ohana, Mickaël Severac, François Radosavljevic, Mirjana Schenck, Malika Kummerlen, Christine Studer, Antoine
source	Medline; PMC
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.
has issue date	2020-08-08(xsd:dateTime)
bibo:doi	10.1186/s13054-020-03200-1
bibo:pmid	32771053
has license	cc-by
sha1sum (hex)	96f018e505a2a7b823f7bd1e17f437d3179daa77
schema:url	https://doi.org/10.1186/s13054-020-03200-1
resource representing a document's title	Delirium and encephalopathy in severe COVID-19: a cohort analysis of ICU patients
has PubMed Central identifier	PMC7414289
has PubMed identifier	32771053
schema:publication	Crit Care
resource representing a document's body	covid:96f018e505a2a7b823f7bd1e17f437d3179daa77#body_text
is schema:about of	named entity 'symptoms' named entity 'patients' named entity 'COVID-19' named entity 'describing' named entity 'ICU' named entity 'SARS-CoV-2' named entity 'Neurotropism' named entity 'rt-pcr' named entity 'SARS-CoV' named entity 'neurological rehabilitation' named entity 'delirium' named entity 'neurological symptoms' named entity 'neurological symptoms' named entity '69.8%' named entity 'Clinical examination' named entity 'CSF analysis' named entity 'CSF analysis' named entity 'cognition' named entity 'endothelial' named entity 'prognosis' named entity 'Vienna' named entity 'intrathecal' named entity 'clinical characteristics' named entity 'ICU' named entity 'transmissible gastroenteritis coronavirus' named entity 'ARDS' named entity 'catecholamines' named entity 'electroencephalographic' named entity 'lung' named entity 'ACE2' named entity 'ICU' named entity 'ICU' named entity 'ICU' named entity 'Delirium' named entity 'lumbar puncture' named entity 'COVID' named entity 'angiotensin-converting enzyme 2' named entity 'cerebrovascular diseases' named entity 'central nervous' named entity '1, 2' named entity 'delirium' named entity 'hypoxemia' named entity 'reverse transcriptase PCR' named entity 'sedation' named entity 'clonus' named entity 'headache' named entity 'acute respiratory failure' named entity 'delirium' named entity 'neurotropic' named entity 'neurological symptoms' named entity 'delirium' named entity 'COVID' named entity 'ICU' named entity 'brain MRI' named entity 'delirium' named entity 'ICU' named entity 'iatrogenic' named entity 'brain MRI' named entity 'ICU' named entity 'inflammatory process' named entity 'delirium' named entity 'confounding factors' named entity 'level of consciousness' named entity 'neuropsychiatric disorders' named entity 'COVID'

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