Publication date: Jun 13, 2025

Older adults are more likely to develop delirium with COVID-19 infection. This cross-sectional cohort study was designed to explore the risk factors of delirium in hospitalized older adults with COVID-19 and to evaluate whether delirium is an independent predictor of mortality in this cohort of patients. Data were collected through a retrospective clinical chart review of patients aged 65 years or older who were admitted to St. James’s Hospital between March 2020 and 2021 who tested positive for SARS-CoV-2 infection. A total of 261 patients (2. 8 % of total admissions 65 years or older) were included in this study. Patients who developed delirium were older (80. 8 v. 75. 8 years, p < 0. 001), more likely to have pre-existing cognitive impairment (OR = 3. 97 [95% CI 2. 11-7. 46], p < 0. 001), and were more likely to be nursing home residents (OR = 12. 32 [95% CI 2. 54-59. 62], p = 0. 0018). Patients who developed delirium had a higher Clinical Frailty score (mean 5. 31 v. 3. 67, p < 0. 001) and higher Charlson Co-morbidity index (mean 2. 38 v. 1. 82, p = .046). There was no significant association between in-hospital mortality and delirium in the patient cohort (p = 0. 13). Delirium was associated with longer hospital stay (40. 5 days v. 21 days, P = 0. 001) and patients with delirium were more likely to be discharged to nursing homes or convalescence instead of home (OR = 8. 46 [95% CI 3. 60-19. 88], p < 0. 001). Delirium is more likely to occur in COVID-19 patients with pre-existing risk factors for delirium, resulting in prolonged admission and functional decline requiring increased support for discharge.

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