Delirium, Paranoid Hallucinations Observed in Covid-19 Patients

Delirium and paranoid hallucinations have been observed in Covid-19 patients who were being treated in ICUs. Numerous patients experienced these hallucinations, including a survivor named Kim Victory who kept on having nightmares and delusions such as she was paralyzed on a bed and being burned alive. As soon as she got rescued, she transformed into an ice sculpture on a fancy cruise ship buffet. Following that, she was subjected to experiments in a lab in Japan, and then she was being attacked by cats.

Another patient named Ms. Victory had been experiencing these delirium and nightmares during her hospitalization this spring for severe respiratory failure caused by the Covid-19. They made her so agitated that one night she pulled out her ventilator breathing tube; another time, she fell off a chair and landed on the floor of the intensive care unit.

“It was so real, and I was so scared,” said Ms. Victory, 31, now back home in Franklin, Tenn.

To an astonishing degree, numerous patients have had been experiencing similar experiences. The paranoid hallucinations and delirium – the phenomenon that has been previously seen mostly in a subset of older patients. Among those elderly, some of them already had dementia, and in recent years, hospitals adopted measures to reduce it.  Dr. E. Wesley Ely, co-director of the Critical Illness, Brain Dysfunction and Survivorship Center at Vanderbilt University and the Nashville Veteran’s Administration Hospital, who had a team specifically to reduce delirium and developed respective guidelines for hospitals. However, due to the advent of Covid-19 those guidelines do not prove enough and hence faced challenges. He said while talking about those guidelines, “All of that has been erased by Covid-19.”

Now with the aggravating and bedeviling coronavirus patients of all ages with no previous cognitive impairment, reports from hospitals and researchers suggest that about 2/3 to 3/4 of coronavirus patients in I.C.U. have experienced delirium and paranoid hallucinations in numerous ways. Some have “hyperactive delirium,” paranoid hallucinations and agitation; some have “hypoactive delirium,” internalized visions and confusion that cause patients to become withdrawn and incommunicative; and some have both.

These experiences are not just terrifying but also disorienting. Delirium can have detrimental consequences long after it lifts, extending hospital stays, slowing recovery and increasing peoples ‘risk of developing depression or post-traumatic stress. Recently, healthy older patients with delirium used to develop these symptoms sooner than they would have and died earlier, researchers have found.

According to Dr. Lawrence Kaplan, director of consultation liaison psychiatry at the University of California, San Francisco Medical Center, there is an increasing risk of temporary or even permanent cognitive deficits, and it is more devastating than our imaginations.

The ingredients for delirium are pervasive during the pandemic. They include long stints on ventilators, heavy sedatives, and poor sleep. Other factors include patients who are mostly immobile, occasionally restrained to keep them from accidentally disconnecting tubes, and receive minimal social interaction because families cannot visit and medical providers wear face-obscuring protective gear and spend limited time in patients ‘rooms.

Source: WHO

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