Delirium

Delirium is a condition characterized by a disturbance of consciousness and a change in cognition or perception. It is commonly observed in patients admitted to the hospital, especially in those with underlying medical conditions or who are critically ill. In recent times, delirium has become a matter of concern in the management of COVID-19 patients as it has been observed in some patients as one of the symptoms of the disease. Delirium presents as a state of confusion and disorientation, with the affected individual experiencing a decreased ability to focus or maintain attention. It may also cause changes in mood, perception, and behavior. Apart from COVID-19, delirium is commonly seen in elderly patients who undergo surgery, experience acute illness, or have a pre-existing cognitive impairment. The underlying causes of delirium could be multifactorial, including metabolic abnormalities, infections, medications, and environmental factors. In COVID-19 patients, the exact mechanisms leading to delirium are still unknown, but it is believed to be related to the direct neurotropic effects of the COVID-19 virus or a secondary effect of the hyperinflammatory state seen in severe COVID-19 patients. Early recognition and treatment of delirium are vital for the management of affected individuals. Non-pharmacologic approaches such as multidisciplinary team-driven interventions, orientation and reorientation, and early mobilization have been shown to be effective in the management of delirium. Pharmacologic interventions are recommended only in selected cases where non-pharmacologic methods have failed, or in severe cases. In conclusion, delirium is a common problem encountered in hospitalized patients and its occurrence in COVID-19 patients warrants a high index of suspicion among medical professionals. Early identification and prompt management are essential in minimizing the short and long-term complications associated with this condition.