tetano
Editor, Senior Moderator
Arch Gerontol Geriatr
. 2020 Dec 30;94:104335.
doi: 10.1016/j.archger.2020.104335. Online ahead of print.
Clinical presentation and mortality in hospitalized patients aged 80+ years with COVID-19-A retrospective cohort study
Linda Katharina Karlsson[SUP] 1 [/SUP], Lasse Hjort Jakobsen[SUP] 2 [/SUP], Louise Hollensberg[SUP] 3 [/SUP], Jesper Ryg[SUP] 4 [/SUP], Mette Midttun[SUP] 1 [/SUP], Henrik Frederiksen[SUP] 5 [/SUP], Andreas Glenth?j[SUP] 6 [/SUP], Anette Raskov Kodahl[SUP] 7 [/SUP], Joanna Secher-Johnsen[SUP] 8 [/SUP], Lene Kongsgaard Nielsen[SUP] 9 [/SUP], Nuria Gonzalez Bofill[SUP] 8 [/SUP], Fredrikke Christie Knudtzen[SUP] 10 [/SUP], Cecilia Margareta Lund[SUP] 11 [/SUP]
Affiliations
Abstract
Background: COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has great health implications in older patients, including high mortality. In general, older patients often have atypical symptom presentations during acute illness due to a high level of comorbidity. The purpose of this study was to investigate the presentation of symptoms at hospital admissions in older patients with COVID-19 and evaluate its impact on disease outcome.
Methods: This retrospective study included patients ≥80 years of age with a positive test for SARS-CoV-2, who were admitted to one of three medical departments in Denmark from March 1st to June 1st, 2020.
Results: A total of 102 patients (47% male) with a mean age of 85 years were included. The most common symptoms at admission were fever (74%), cough (62%), and shortness of breath (54%). Furthermore, atypical symptoms like confusion (29%), difficulty walking (13%), and falls (8%) were also present. In-hospital and 30-day mortality were 31% (n = 32) and 41% (n = 42), respectively. Mortality was highest in patients with confusion (50% vs 38%) or falls (63% vs 39%), and nursing home residency prior to hospital admission was associated with higher mortality (OR 2.7, 95% CI 1.1-6.7).
Conclusions: Older patients with SARS-Cov-2 displayed classical symptoms of COVID-19 but also geriatric frailty symptoms such as confusion and walking impairments. Additionally, both in-hospital and 30-day mortality was very high. Our study highlights the need for preventive efforts to keep older people from getting COVID-19 and increased awareness of frailty among those with COVID-19.
Keywords: Delirium; Falls; Frailty; Multimorbidities; SARS-CoV-2.
. 2020 Dec 30;94:104335.
doi: 10.1016/j.archger.2020.104335. Online ahead of print.
Clinical presentation and mortality in hospitalized patients aged 80+ years with COVID-19-A retrospective cohort study
Linda Katharina Karlsson[SUP] 1 [/SUP], Lasse Hjort Jakobsen[SUP] 2 [/SUP], Louise Hollensberg[SUP] 3 [/SUP], Jesper Ryg[SUP] 4 [/SUP], Mette Midttun[SUP] 1 [/SUP], Henrik Frederiksen[SUP] 5 [/SUP], Andreas Glenth?j[SUP] 6 [/SUP], Anette Raskov Kodahl[SUP] 7 [/SUP], Joanna Secher-Johnsen[SUP] 8 [/SUP], Lene Kongsgaard Nielsen[SUP] 9 [/SUP], Nuria Gonzalez Bofill[SUP] 8 [/SUP], Fredrikke Christie Knudtzen[SUP] 10 [/SUP], Cecilia Margareta Lund[SUP] 11 [/SUP]
Affiliations
- PMID: 33476754
- DOI: 10.1016/j.archger.2020.104335
Abstract
Background: COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has great health implications in older patients, including high mortality. In general, older patients often have atypical symptom presentations during acute illness due to a high level of comorbidity. The purpose of this study was to investigate the presentation of symptoms at hospital admissions in older patients with COVID-19 and evaluate its impact on disease outcome.
Methods: This retrospective study included patients ≥80 years of age with a positive test for SARS-CoV-2, who were admitted to one of three medical departments in Denmark from March 1st to June 1st, 2020.
Results: A total of 102 patients (47% male) with a mean age of 85 years were included. The most common symptoms at admission were fever (74%), cough (62%), and shortness of breath (54%). Furthermore, atypical symptoms like confusion (29%), difficulty walking (13%), and falls (8%) were also present. In-hospital and 30-day mortality were 31% (n = 32) and 41% (n = 42), respectively. Mortality was highest in patients with confusion (50% vs 38%) or falls (63% vs 39%), and nursing home residency prior to hospital admission was associated with higher mortality (OR 2.7, 95% CI 1.1-6.7).
Conclusions: Older patients with SARS-Cov-2 displayed classical symptoms of COVID-19 but also geriatric frailty symptoms such as confusion and walking impairments. Additionally, both in-hospital and 30-day mortality was very high. Our study highlights the need for preventive efforts to keep older people from getting COVID-19 and increased awareness of frailty among those with COVID-19.
Keywords: Delirium; Falls; Frailty; Multimorbidities; SARS-CoV-2.