Article Data

  • Views 2565
  • Dowloads 242

Case Reports

Open Access

Delirium in critically ill patients with COVID-19 pneumonia

  • Hai Zou1
  • Wan-Feng Xiong1
  • Sheng-Qing Li1

1Department of Respiratory Medicine, Huashan Hospital, Fudan University, 200433 Shanghai, P. R. China

DOI: 10.22514/sv.2021.013 Vol.17,Issue 2,March 2021 pp.216-218

Published: 08 March 2021

*Corresponding Author(s): Hai Zou E-mail:


The ICU delirium is a predictor of mortality, length of stay in hospital, time on ventilation, and long-term cognitive impairment. There is a well-established association between acute respiratory distress syndrome (ARDS) and ICU delirium. However, the profile and disease progression trajectory of COVID-19 patients with ICU delirium has not been studied. This case series reviews our institution’s experience in COVID-19 patients with ICU delirium. Of all four patients, two of them died in hospital, and the other two survived to the hospital discharge. The disease progressions were tracked, as well as the ICU delirium. Potential life-threatening complications and organ failure symptoms were also presented. To improve the patients’ overall health outcome, Haloperidol was prescribed with careful consideration.


Delirium; COVID-19; ICU

Cite and Share

Hai Zou,Wan-Feng Xiong,Sheng-Qing Li. Delirium in critically ill patients with COVID-19 pneumonia. Signa Vitae. 2021. 17(2);216-218.


[1] Richman DD, Whitley RJ, Hayden FG. Clinical virology. 4th edn. Washington, DC: ASM Press. 2016.

[2] Ksiazek TG, Erdman D, Goldsmith CS, Zaki SR, Peret T, Emery S, et al. A novel coronavirus associated with severe acute respiratory syndrome. The New England Journal of Medicine. 2003; 348: 1953-1966.

[3] Kuiken T, Fouchier RA, Schutten M, Rimmelzwaan GF, van Amerongen G, van Riel D, et al. Newly discovered coronavirus as the primary cause of severe acute respiratory syndrome. The Lancet. 2003; 362: 263-270.

[4] Drosten C, Günther S, Preiser W, van der Werf S, Brodt HR, Becker S, et al. Identification of a novel coronavirus in patients with severe acute respiratory syndrome. The New England Journal of Medicine. 2003; 348: 1967-1976.

[5] de Groot RJ, Baker SC, Baric RS, Brown CS, Drosten C, Enjuanes L, et al. Middle East Respiratory Syndrome Coronavirus (MERS-CoV): announcement of the coronavirus study group. Journal of Virology. 2013; 87: 7790-7792.

[6] Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus ADME, Fouchier RAM. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. The New England Journal of Medicine. 2012; 367: 1814-1820.

[7] Wang W, Fasolino M, Cattau B, Goldman N, Kong W, Frederick MA, et al. Joint profiling of chromatin accessibility and CAR-T integration site analysis at population and single-cell levels. Proceedings of the National Academy of Sciences. 2020; 117: 5442-5452.

[8] Klankluang W, Pukrittayakamee P, Atsariyasing W, Siriussawakul A, Chanthong P, Tongsai S, et al. Validity and reliability of the Memorial Delirium Assessment Scale-Thai version (MDAS-T) for assessment of delirium in palliative care patients. The Oncologist. 2020; 25: e335-e340.

[9] Hosie A, Davidson PM, Agar M, Sanderson CR, Phillips J. Delirium prevalence, incidence, and implications for screening in specialist pal-liative care inpatient settings: a systematic review. Palliative Medicine. 2013; 27: 486-498.

[10] van Zyl LT, Seitz DP. Delirium concisely: condition is associated with increased morbidity, mortality, and length of hospitalization. Geriatrics. 2006; 61: 18-21.

[11] van den Boogaard M, Wassenaar A, van Haren FMP, Slooter AJC, Jorens PG, van der Jagt M, et al. Influence of sedation on delirium recognition in critically ill patients: a multinational cohort study. Australian Critical Care. 2020; 33: 420-425.

[12] Hsieh SJ, Soto GJ, Hope AA, Ponea A, Gong MN. The association between acute respiratory distress syndrome, delirium, and in-hospital mortality in intensive care unit patients. American Journal of Respiratory and Critical Care Medicine. 2015; 191: 71-78.

[13] Chen T, Chung Y, Chang H, Chen P, Wu C, Hsieh S, et al. Diagnostic accuracy of the CAM-ICU and ICDSC in detecting intensive care unit delirium: a bivariate meta-analysis. International Journal of Nursing Studies. 2021; 113: 103782.

[14] Zhao W, Hu Y, Chen H, Wang X, Wang L, Wang Y, et al. The effect and optimal dosage of dexmedetomidine plus sufentanil for postop-erative analgesia in elderly patients with postoperative delirium and early postoperative cognitive dysfunction: a single-center, prospective, randomized, double-blind, controlled trial. Frontiers in Neuroscience. 2020; 14: 549516.

[15] Ely EW, Inouye SK, Bernard GR, Gordon S, Francis J, May L, et al. Delirium in mechanically ventilated patients: validity and reliability of the confusion assessment method for the intensive care unit (CAM-ICU). Journal of the American Medical Association. 2001; 286: 2703-2710.

[16] Davis DHJ, Muniz Terrera G, Keage HAD, Stephan BCM, Fleming J, Ince PG, et al. Association of delirium with cognitive decline in late life: a neuropathologic study of 3 population-based cohort studies. JAMA Psychiatry. 2017; 74: 244-251.

[17] Girard TD, Exline MC, Carson SS, Hough CL, Rock P, Gong MN, et al. Haloperidol and ziprasidone for treatment of delirium in critical illness. The New England Journal of Medicine. 2018; 379: 2506-2516.

[18] Kotfis K, Williams Roberson S, Wilson JE, Dabrowski W, Pun BT, Ely EW. COVID-19: ICU delirium management during SARS-CoV-2 pandemic. Critical Care. 2020; 24: 176-184.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time