UNC Pulmonary Diseases and Critical Care Medicine Fellow, Emma Bick, MD, MPH, in collaboration with Assistant Professors of Medicine Benjamin J. Sines, MD, MSCR, and C. Adrian Austin, MD, MSCR, recently published a paper in Critical Care Explorations. The observational study examined how the COVID-19 pandemic affected the prevalence of substance use and delirium complicating ICU and floor admissions. Their findings highlighted a variety of different trends during the pre-pandemic, onset, and recovery phases of COVID-19.
They found that before the pandemic, ICU admissions complicated by substance use were declining. The onset of COVID-19 marked a significant reversal in the trend that continued into the recovery phase of the pandemic. Floor admissions complicated by substance use were gradually decreasing pre-pandemic, remained steady during the lockdowns but increased in the recovery phase. Delirium in the ICU was declining pre-pandemic, but rose sharply at the start of lockdowns, and declined over the course of the pandemic. Finally, delirium prevalence on the floor was rising before the pandemic and remained stagnant during the peak and has continued to increase in the recovery phase.
The paper cites the three most striking findings as:
- The immediate increase in documented delirium at the beginning of COVID-19
- The gradual decline in ICU delirium during and after the pandemic
- The rise in substance use prevalence during and after the pandemic both on the floor and in the ICU
The researchers’ findings emphasize the need for ongoing monitoring and tailored interventions to manage substance use and delirium in hospitalized patients.