Delirium in COVID-19

Main Article Content

Yanin Thipakorn
Paul Thisayakorn


Objectives : To review current literature relevant to delirium in COVID-19 patients including the signs and symptoms, pathophysiology, risk factors, treatment outcomes, diagnosis, prevention, and treatment.

Methods : 114 Articles relevant to delirium, COVID-19, and delirium/confusion in COVID-19 published between 1946-2021 were searched from the MEDLINE/PubMed database. Narrative review was conducted and synthesis.

Results : Delirium is a common complication of COVID-19 patients and may also be a presenting symptom. The pathophysiology of delirium in COVID19 infection may be due to severe infection and illness as well as necessary treatments, due to direct neuroinvasion of the SARS-CoV-2 virus and may also be precipitated by environmental challenges designed for preventing viral transmission. Delirium is associated with adverse treatment outcomes as well as long-term deterioration of function. Patients with severe illness, advanced age, or history of neurological diseases are at higher risk, and may benefit from screening with validated tools. Adequate pain control, physical therapy and rehabilitation, and family engagement are part of effective prevention strategies. Despite restrictions on family visitation, virtual communication with family members can still be protective. Pharmacological management may be necessary and drug interactions with other COVID treatments should be monitored.

Conclusion: Delirium is a preventable condition of COVID-19 patients and is related to worse outcomes. Close monitoring of high-risk patients can lead to prompt and proper treatment of delirium, therefore improving outcomes of hospitalization.


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Thipakorn, Y., & Thisayakorn, P. (2021). Delirium in COVID-19. Journal of the Psychiatric Association of Thailand, 66(4), 469–488. Retrieved from
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