Delirium in COVID patients: recommendations for assessment and treatment

COVID-19 patients, particularly those admitted to an Intensive Care Unit, are at high risk of Delirium due to the frequently observed concomitant presence of a series of factors which, taken together, constitute an increased risk factor. Factors thought to play a key role include: a direct action of the virus and state of inflammation on the Central Nervous System; secondary effects of organ failure; effect of sedative treatment; prolonged exposure to mechanical ventilation; prolonged immobilisation; environmental factors including social isolation and restricted interaction with relatives and healthcare operators. Bearing in mind the potential impact of delirium on clinical outcome, with an increased risk of death, appropriate prevention and management of this condition, particularly complex in COVID patients due to the frequently observed concomitant presence of numerous predisposing and precipitating factors, is fundamental.