Table of contents:
- Delirium in elderly COVID-19 patients
- What causes delirium in COVID-19 patients?
- Management of delirium in COVID-19 patients
Delirium is a condition of disorientation or loss of power to recognize the environment, especially time, place, and people. This delirium condition sometimes occurs in elderly patients with COVID-19, and can be a sign of a serious condition.
Delirium in elderly COVID-19 patients
The disease caused by the SARS-CoV-2 virus is not yet fully known by experts. Currently, research on the symptoms and conditions related to COVID-19 infection is still being conducted. One of the conditions due to COVID-19 infection that has not been known for a long time is that COVID-19 infection can trigger delirium syndrome, especially in elderly patients.
Delirium is also called acute confusion syndrome which is characterized by changes in the level of consciousness, disorientation, inattention, and other cognitive disorders. Generally, the patient will experience confusion such as not knowing where he is, not knowing the change in time, and not being able to recognize the person he is talking to.
Because delirium is acute confusion syndrome, it means that the condition of confusion occurs suddenly, not previously dementia. For example, yesterday was still connected when spoken to, suddenly today it is not connected or can not distinguish between children or grandchildren who are being spoken to.
This condition of acute confusion is common in patients over 60 years of age who have serious illnesses. We often get delirium in elderly patients who are being treated for diabetes, pulmonary infectious diseases, patients prior to surgery, and many other ailments.
Currently, we also often find delirium in elderly people who are infected with COVID-19. Unfortunately, about 70% of delirium cases in COVID-19 patients are still not detected properly. Even though delirium can be a sign of worsening COVID-19 infection, leading to severe or critical symptoms.
In non-COVID-19 patients, delirium can even be the only sign of infection in the elderly without any special symptoms.
What causes delirium in COVID-19 patients?
The cause of delirium in elderly COVID-19 patients mostly occurs because patients experience hypoxia or very low levels of oxygen in the blood. Lack of oxygen supply to the brain is at risk of impairing cognitive function and memory in patients.
Symptoms of hypoxia often occur in patients with moderate, severe, and critical symptoms of COVID-19.
In second place, the causes of delirium in elderly COVID-19 patients occur due to disruption of blood flow to the brain. One of the many dangers of this viral infection is that it causes blood to clot, obstructing blood flow to the brain. As a result, the brain does not get enough nutrition and triggers delirium.
Delirium in elderly COVID-19 patients can also occur because the patient experiences it cytokine storm or cytokine storms as an over-response of the immune system to viruses. This cytokine storm causes inflammatory substances (inflammation) to disrupt the balance of enzymes in the brain and create acute confusion.
Apart from causes that occur due to physical problems, delirium can also occur due to maladaptation. Changes in the environment that suddenly made him easily confused, for example at home he was accustomed to being surrounded by children and grandchildren and suddenly moved to an isolation room. A room much colder than the room in his house, bright lights, no one he recognized, and other unfamiliar conditions.
Failure to adapt to these environmental changes also easily confuses the elderly and can be one of the triggers for delirium in COVID-19 patients.
Management of delirium in COVID-19 patients
Patients with delirium can be characterized by tantrums and making a fuss, this type is called hyperactivity and is one that is easy to detect. But other types it is often difficult to tell if the patient has delirium. For example, in the hypoactive type, there is something that makes the patient fall asleep frequently, makes people around him think he is tired or really wants to rest.
First of all, the precautions for delirium in COVID-19 patients must be increased. Elderly with COVID-19 who are self-isolating must be immediately taken to the hospital because delirium can be a sign of severe symptoms without other symptoms.
The condition of delirium is not permanent, it can return to normal when the underlying disease is treated successfully. For example delirium due to hypoxia, the oxygen supply in the body must be handled.
However, the age factor makes the recovery condition likely not 100% back to normal. It is possible that residual confusion will become chronic and lead to senility or Alzheimer's. But we hope that delirium in COVID-19 patients is detected quickly and can recover.
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