J Korean Med Sci.  2024 Aug;39(32):e232. 10.3346/jkms.2024.39.e232.

Associations Between COVID-19, Delirium, and 1-Year Mortality: Exploring Influences on Delirium Incidence in COVID-19 Patients

• Jang Y
• Hur HJ
• Myung W
• Park EJ
• Park HY

• KMID: 2558531
• DOI: http://doi.org/10.3346/jkms.2024.39.e232

Abstract

Background
This study investigated the relationship between coronavirus disease 2019 (COVID-19), delirium, and 1-year mortality. Factors associated with delirium in COVID-19 patients were identified, along with the influence of psychotropic medications on delirium.
Methods
The study used the South Korean National Health Insurance Service database. Adult COVID-19 patients diagnosed between October 2020 and December 2021 were included, with a propensity score-matched control group. Time-dependent Cox regression assessed associations among COVID-19, delirium, and mortality. Logistic regression analyzed the impact of psychotropic medications on delirium incidence.
Results
The study included 832,602 individuals, with 416,301 COVID-19 patients. COVID-19 (hazard ratio [HR], 3.03; 95% confidence interval [CI], 2.92–3.13) and delirium (HR, 2.33; 95% CI, 2.06–2.63) were independent risk factors for 1-year mortality. Comorbidities, insurance type, and residence were also related to mortality. Among COVID-19 patients, antipsychotic use was associated with lower delirium incidence (odds ratio [OR], 0.38; 95% CI, 0.30–0.47), while mood stabilizers (OR, 1.77; 95% CI, 1.40–2.21) and benzodiazepines (OR, 8.62; 95% CI, 7.46–9.97) were linked to higher delirium incidence.
Conclusion
COVID-19 and delirium are risk factors for 1-year mortality. Some factors associated with delirium in COVID-19 patients are modifiable and can be targeted in preventive and therapeutic interventions.

Keyword

COVID-19; Delirium; Medications; Mortality; Risk Factors

Figure

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  Fig. 1 Extended Kaplan–Meier curves between COVID-19 patients and the control group (A), as well as between patients with delirium and those without delirium (B) in study 1.COVID-19 = coronavirus disease 2019.

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