COVID: The By no means-Ending Trauma Now Options Delirium!
“I thought I just had lung disease. Why am i crying Why can’t I think clearly for more than five minutes? “Is a common sentiment shared by Dr. Craig Weinert, an intensive care doctor and pulmonologist at the University of Minnesota, is heard. This is the unexpected aftereffect common to many COVID-19 patients after the intensive care unit: delirium.
As if the fear of a global pandemic wasn’t enough, many surviving patients of COVID-19 disease are now reporting severe cases of delirium. What is confusing about this effect is that it does not discriminate against age or cause previous illnesses.
What is delirium?
Delirium is a severe state of confusion that increases the risk of other health complications and results in death after surgery or treatment for other diseases. Delirium is a common, albeit terrifying, effect in many elderly patients. Even so, it seems to have become an epidemic of its own, affecting patients of all ages. This includes one-third of the hospitalized patients and two-thirds of the patients with serious illnesses during the novel virus period. Health professionals are now concerned that years of advances in hard-won practices that reduce the risk of delirium are long gone.
A study by the New England Journal of Medicine of neurological features in severe SARS-CoV-2 infection found that 65 percent of coronavirus patients in the hospital had delirium. This means that more than half of the patients with severe cases of COVID-19 experience long-term nightmarish hallucinations, disorientation, irritability, and other unexpected cognitive changes.
While families may have loved ones back physically, they may have to claim they lost them spiritually. This seems to be the inevitable promise after COVID-19.
The delirium horrors: Causes and effects
Causes of delirium
Experts claim that delirium is prevalent in coronavirus patients for a number of reasons. These include the long periods of time spent on ventilators in the intensive care unit and other factors unique to the virus such as the use of sedatives and isolation.
A 2017 study found that 80 percent of patients who spend time in ventilators have delirium. The effects occur because of the sedatives offered to patients, the external environmental conditions in the intensive care unit, and the patients’ limited oxygen consumption.
However, it is certain that the unique characteristics of the novel coronavirus will cause delirium to be much more common in patients.
The obvious response to coronavirus treatment is to take patients to the hospital for medical care. However, the effects of hospitalization cannot be intuitive. These hospital patients are kept in isolation. You won’t have a loved one to hold your hand, talk to you, or remind you of your identity outside of the hospital.
In addition, patients are exposed to other sick patients and practitioners who constantly remind them of their illness. The ventilators themselves are not a favorable condition for a patient who is staying for long periods of time – the limited amount of oxygen may not be sufficient for brain function.
The result is an environment that makes it easy to induce delirium, and it gets worse the longer the patient is in the hospital.
Under normal circumstances, doctors use sedatives that reduce or prevent the occurrence of delirium in ICU patients. But with the disaster that turned out to be a pandemic, medicine is scarce, forcing doctors to use drugs that cause more delirium than others.
Unknown effects of the virus
Experts speculate that the virus could enter the brain in ways that have yet to be determined. It doesn’t help that most patients in the intensive care unit have previous underlying medical conditions that make them more prone to delirium. Such conditions include Parkinson’s disease, stroke, and dementia.
Patients who have previously been admitted to the intensive care unit, have had heart problems, or have hip surgery are also more prone to delirium. However, delirium does not discriminate against age or previous chronic illnesses. So everyone is at risk.
Effects of Delirium
A common occurrence during delirium in the intensive care unit is that patients develop false and very scary memories. The delusions are usually based on real stimuli, which make their effects much worse than ordinary nightmares.
“I had these hallucinations that would make me pass out – falling really slowly. I remember specifically having thoughts like, Oh, I’m dying, and it will hurt when I hit my face on the floor. At some point I saw my funeral. I remember seeing my mother at my funeral. It was really traumatic, ”says Vanderhoof, a week long ventilator, of his experience during the treatment.
Many of the COVID-19 sufferers experience hallucinations related to their deaths from assault or torture. Jim Jackson, a psychologist at Vanderbilt University’s Medical ICU Recovery Center, believes these harrowing delusions reflect the stress and real pain of their condition.
The occupational therapist Alyssa Gartenberg reports that the effects of delirium change every hour. It can be either hypoactive or hyperactive. When a patient is hypoactive, they appear dizzy and sluggish. When they’re hyperactive, they get excited and wired. It is common for a patient to experience both cases.
A serious disadvantage of delirium is that it blocks the patient’s recovery from being unable to rehabilitate. One study also found that delirium predicts prolonged ICU stays, cognitive mortality, and in some cases, death.
The cognitive effects of delirium extend beyond the hospital and into family homes and workplaces. Patients who have been in the intensive care unit suffer from other diseases in the long term, such as post-ICU syndrome. This is a group of symptoms that includes brain fog, physical weakness, and bad mood after intensive care. It is especially common after using ventilators, which confirms the notion that the person was about to die. The sedatives could also contribute to these unexpected mental health effects.
According to statistics, intensive care affects 50 percent of the intensive care unit and 33 percent of ventilated patients within a one-week hospital stay. Worst of these effects is that there is no proven treatment for delirium and patients cannot seek help until they have reached clinical levels of anxiety or depression.
In the meantime, patients and their families feel drained for months or years. In worse cases, 10 percent of ICU patients experience life-changing and persistent cognitive effects that lead to medical post-traumatic stress disorder (PTSD). This is a common likelihood in coronavirus patients.
Delirium Treatments: Is There A Way Out?
Although the effects of the disease can last months or even years, there are no exact treatments for delirium. However, there is hope that most novel coronavirus patients will survive the psychological consequences of a ventilator. One patient, Michael Goldsmith, suffered from delirium after a 22-day medically induced coma. The delirium has since faded but leaves some side effects like fatigue, hearing loss, and numbness in the skull. His post-COVID progress has been fantastic and his family is hoping it all clears up in time. According to studies, many COVID-19 patients will not face long-term psychiatric problems after treatment for delirium, just like Goldsmith.
Much of Michael’s recovery is attributed to the health of his health team. While some nurses held his hand, others held a phone to Michael’s ear when his family spoke to him. The sensible measures taken by hospital staff can make a major contribution to ensuring that many patients recover fully after COVID.
Connecting patients with families through technology is also proving to be a significant boost to delirium management. Support for post-intensive care recovery programs should also be increased. Teams should be formed to address the cognitive and psychiatric problems, family stress, and physical debilitation and then their effectiveness should be assessed.
A number of studies also support the use of non-pharmacological CAM therapies to treat delirium and agitation. Such holistic therapies include acupuncture, massage, and aromatherapy. However, various studies of delirium, COVID-19, and these therapies are needed to determine the effectiveness of these alternative treatments.
How victims deal with fallout
The delirium and hallucination effects are evident in patients long after they are discharged from hospital. Most patients experience physical fatigue and a wave of symptoms such as intermittent fever, loss of smell and taste, and difficulty breathing. In some cases, simple pleasures like reading a book or practicing yoga become a challenge.
Many patients speak to psychologists to address areas of their life that cause anxiety. Patients also talk to families, manage their sleep, and eat. However, care is taken to ensure that these patients do not become figureheads for the coronavirus pandemic.