In older adults presenting to the emergency department with coronavirus 2019 (COVID-19), delirium was common and often was seen without other typical symptoms or signs, according to the results of a recent study published in JAMA Open Network.

Medical records were evaluated from adults aged 65 years or older who presented to the emergency room with COVID-19 at 7 sites within the United States. COVID-19 was diagnosed by positive nasal swab for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or classic radiological findings. The primary study outcome was delirium, which was identified according to a validated record review approach

Among the 817 older patients with COVID-19 included in the analysis, 47% were male, 62% were white, and the mean patient age was 77.7 years. A total of 28% of patients presented with delirium. Among these patients, 16% had delirium as a primary symptom, and 37% had no typical COVID-19 symptoms. Delirium was associated with intensive care unit stay and death.

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“Delirium was associated with poor hospital outcomes and death,” the study authors determined. They added, “These findings suggest the clinical importance of including delirium on checklists of presenting signs and symptoms of COVID-19 that guide screening, testing, and evaluation.”


Kennedy M, Helfand BKI, Gou RY, et al. Delirium in Older Patients With COVID-19 Presenting to the Emergency Department. JAMA Netw Open. 2020;3(11):e2029540. Published online November 19, 2020. doi: 10.1001/jamanetworkopen.2020.29540

This article originally appeared on Pulmonology Advisor