Long-term sequelae of acute respiratory distress syndrome caused by severe community-acquired pneumonia: Delirium-associated cognitive impairment and post-traumatic stress disorder

Abstract

ObjectiveDelirium in critically ill patients is considered a risk factor for various long-term consequences. We evaluated delirium and associated long-term outcomes in patients with acute respiratory distress syndrome with non-H1N1 and H1N1- associated severe community-acquired pneumonia (sCAP) who had been recommended to take antiviral drugs associated with delirious symptoms as adverse effects.MethodsOf 64 patients, 42 survivors (H1N1, 15; non-H1N1, 27) were analyzed regarding the relationship between medication and the duration of delirium in the intensive care unit. During follow-up (n = 23), we assessed cognitive abilities, post-traumatic stress disorder (PTSD), physical capacity, and health-related quality of life (HRQoL).ResultsThe incidence of delirium was 88%. There was no difference in the incidence and duration of delirium between patients with H1N1 and non-H1N1 infection. The haloperidol and opioid doses were associated with a longer delirium duration. The delirium duration was correlated with reduced cognitive performance in motor skills, memory function, and learning efficiency. Patients with PTSD (16%) had a significantly longer delirium duration and low mental HRQoL.ConclusionsH1N1 infection and corresponding antiviral medication had no impact on delirium. The duration of delirium in these patients was associated with impairments in various outcome parameters, illustrating the burden of sCAP.

Frailty Pathogenesis, Assessment, and Management in Older Adults With COVID-19

“…About the impact of infections on physical function, only three studies performed objective physical and motor function tests, which targeted different physical domains (35)(36)(37). Despite the methodological heterogeneity, most studies support the hypothesis that infections impair physical function.…”

Depression and insomnia in COVID-19 survivors: a cross-sectional survey from Chinese rehabilitation centers in Anhui province

“…Up to now, there have been few studies on the psychological follow-up investigation of the recovered COVID-19 patients. However, many previous studies have explored the mental health problems of patients after recovery and discharge from the hospital under a major epidemic [ [21] , [22] , [23] , [24] ]. Claudia et al [ 21 ] reported a study on cognitive abilities, post-traumatic stress disorder (PTSD), and health-related quality of life (HRQoL) in patients during follow-up.…”

“…However, many previous studies have explored the mental health problems of patients after recovery and discharge from the hospital under a major epidemic [ [21] , [22] , [23] , [24] ]. Claudia et al [ 21 ] reported a study on cognitive abilities, post-traumatic stress disorder (PTSD), and health-related quality of life (HRQoL) in patients during follow-up. They found that survivors of severe community-acquired pneumonia and acute respiratory distress syndrome had a relatively high incidence of cognitive dysfunction, reduced functional capacity, and high incidence of PTSD that was associated with diminished HRQoL and a decreased rate of return to work.…”

Delirium and long term cognition in critically ill patients

“…For many people, an acute hospital admission, especially one that includes an ICU stay, results in new or worsening cognitive decline 11120121122123124. In a multicenter cohort of 821 critically ill patients with respiratory failure or shock, one in four ICU survivors, across all adult age groups, had cognitive impairment one year after discharge, equating in severity to that of having mild Alzheimer’s disease or moderate traumatic brain injury 11.…”