tetano
Editor, Senior Moderator
Aging Med (Milton)
. 2020 Sep 17;3(4):237-244.
doi: 10.1002/agm2.12126. eCollection 2020 Dec.
Atypical presentations of COVID-19 in care home residents presenting to secondary care: A UK single centre study
Mark James Rawle[SUP] 1 2 [/SUP], Deborah Lee Bertfield[SUP] 1 [/SUP], Simon Edward Brill[SUP] 3 [/SUP]
Affiliations
Abstract
Background: Atypical presentations of COVID-19 pose difficulties for early isolation and treatment, particularly in institutional care settings. We aimed to characterize the presenting symptoms and associated mortality of COVID-19 in older adults, focusing on care home residents admitted to secondary care.
Methods: A retrospective cohort study of 134 consecutive inpatients over 80 years old hospitalized with PCR confirmed COVID-19 in the United Kingdom. Symptoms at presentation and frailty were analysed. Differences between community dwelling and care home residents, and associations with mortality, were assessed using between-group comparisons and logistic regression.
Results: Care home residents were less likely to experience cough (46.9% vs 72.9%, P = .002) but more likely to present with delirium (51.6% vs 31.4%, P = .018), particularly hypoactive delirium (40.6% vs 24.3%, P = .043). Mortality was more likely with increasing frailty (OR 1.25, 95% CI 1.00, 1.58, P = .049) and those presenting with anorexia (OR 3.20, 95% CI 1.21, 10.09, P = .028). There were no differences in mortality or length of stay based on residential status.
Conclusion: COVID-19 in older adults often presents with atypical symptoms, particularly in those admitted from institutional care. These individuals have a reduced incidence of cough and increased hypoactive delirium. Individuals presenting atypically, especially with anorexia, have higher mortality.
Keywords: coronavirus; delirium; frailty; nursing home; residential home; symptoms.
. 2020 Sep 17;3(4):237-244.
doi: 10.1002/agm2.12126. eCollection 2020 Dec.
Atypical presentations of COVID-19 in care home residents presenting to secondary care: A UK single centre study
Mark James Rawle[SUP] 1 2 [/SUP], Deborah Lee Bertfield[SUP] 1 [/SUP], Simon Edward Brill[SUP] 3 [/SUP]
Affiliations
- PMID: 33392429
- PMCID: PMC7771562
- DOI: 10.1002/agm2.12126
Abstract
Background: Atypical presentations of COVID-19 pose difficulties for early isolation and treatment, particularly in institutional care settings. We aimed to characterize the presenting symptoms and associated mortality of COVID-19 in older adults, focusing on care home residents admitted to secondary care.
Methods: A retrospective cohort study of 134 consecutive inpatients over 80 years old hospitalized with PCR confirmed COVID-19 in the United Kingdom. Symptoms at presentation and frailty were analysed. Differences between community dwelling and care home residents, and associations with mortality, were assessed using between-group comparisons and logistic regression.
Results: Care home residents were less likely to experience cough (46.9% vs 72.9%, P = .002) but more likely to present with delirium (51.6% vs 31.4%, P = .018), particularly hypoactive delirium (40.6% vs 24.3%, P = .043). Mortality was more likely with increasing frailty (OR 1.25, 95% CI 1.00, 1.58, P = .049) and those presenting with anorexia (OR 3.20, 95% CI 1.21, 10.09, P = .028). There were no differences in mortality or length of stay based on residential status.
Conclusion: COVID-19 in older adults often presents with atypical symptoms, particularly in those admitted from institutional care. These individuals have a reduced incidence of cough and increased hypoactive delirium. Individuals presenting atypically, especially with anorexia, have higher mortality.
Keywords: coronavirus; delirium; frailty; nursing home; residential home; symptoms.