Risk Factors, Symptomatology, and Predictors of Mortality among COVID-19 Inpatients Presenting with Delirium Symptoms in a Tertiary Hospital in the Philippines

Abstract INTRODUCTION Delirium is a common but under-recognized finding among patients with COVID-19. This study aimed to describe the risk factors, symptomatology, and predictors of mortality of COVID-19 patients presenting with delirium symptoms admitted in 2021 to the Philippine General Hospital, a public tertiary hospital in the Philippines. METHODS Medical records of adult COVID-19 patients admitted to the Philippine General Hospital in 2021 were analyzed. Descriptive statistics were used to summarize the demographic and clinical history. Univariate and multivariate logistic regression were done to determine the variables that are predictive of mortality. RESULTS Four hundred patients with COVID-19 had delirium symptoms. Of those, 36.5% were not diagnosed with delirium, only 7% were referred to Psychiatry, and 74% expired during their admission. Patients referred to Psychiatry have lower odds of mortality compared to those not referred (aOR=0.069, p=0.014); those that received midazolam had higher odds of mortality (aOR=3.112, p=0.001). Patients on mechanical ventilation (aOR=20.172), those placed on prone positioning during mechanical ventilation (aOR=6.272), those with decreased sensorium (aOR=7.438), and those with decreased psychomotor activity (aOR=3.857) all had higher odds of mortality (p<0.001). CONCLUSIONS Timely assessment and appropriate management are critical for COVID-19 patients with delirium symptoms, especially those at an increased risk for mortality. Clinicians dealing with COVID-19 patients presenting with delirium symptoms need to be reoriented to delirium symptomatology, initial interventions, and indications for referral to psychiatrists.