tetano
Editor, Senior Moderator
Gerontology
. 2022 Jan 31;1-9.
doi: 10.1159/000521412. Online ahead of print.
Frail Older Adults with Presymptomatic SARS-CoV-2 Infection: Clinical Course and Prognosis
Yochai Levy[SUP] 1 2 [/SUP], Adi Turjeman[SUP] 2 3 [/SUP], Lisa Cooper[SUP] 1 2 [/SUP], Nadya Kagansky[SUP] 2 4 [/SUP], Tatiana Nagulevich[SUP] 5 [/SUP], Tamari Snir[SUP] 5 [/SUP], Avital Hershkovitz[SUP] 2 6 [/SUP], Avraham Weiss[SUP] 1 2 [/SUP], Yichayaou Beloosesky[SUP] 1 2 [/SUP], Yaara Leibovici Weissman[SUP] 2 7 [/SUP]
Affiliations
Abstract
Background/aims: The novel coronavirus SARS-CoV-2 has caused a pandemic threatening millions of people worldwide. This study aimed to describe clinical characteristics, outcomes, and risk factors of SARS-CoV-2-positive, asymptomatic, frail older adults.
Methods: A retrospective cohort study was conducted in 6 designated COVID-19 units, in skilled nursing homes. Subjects were severely frail older adults, positive for SARS-CoV-2, and asymptomatic at the time of their admission in these units. Residents' characteristics and symptoms were obtained via electronic medical records. The primary outcome was a composite of death or hospitalization by day 40. We looked at time to the primary outcome and used Cox regression for a multivariate analysis.
Results: During March-November 2020, 849 residents met inclusion criteria. Median age was 84 years. Most were completely dependent for basic activities of daily living and showed cognitive impairment. Six hundred forty-one (75.5%) residents were discharged after considered cured from COVID-19, 125 (14.7%) were hospitalized, and 82 (9.7%) died in the facilities. In survival analysis, 35% reached the primary outcome of death or hospitalization by day 40. Age (hazard ratio
1.23; 95% confidence interval [CI] 1.1-1.4), male gender (HR 1.41; 95% CI: 1.1-1.88), and COPD (HR 1.8; 95% CI: 1.23-2.67) were significant risk factors.
Conclusions: In this large cohort, we report care and prognosis of asymptomatic older adults with major functional or cognitive impairments during the COVID-19 pandemic. Most presymptomatic patients do not develop severe infection, and age stays a predominant risk factor, even in the frailest older adults.
Keywords: Coronavirus disease; Frailty; Long-term care; Older adults; Vitamin D.
. 2022 Jan 31;1-9.
doi: 10.1159/000521412. Online ahead of print.
Frail Older Adults with Presymptomatic SARS-CoV-2 Infection: Clinical Course and Prognosis
Yochai Levy[SUP] 1 2 [/SUP], Adi Turjeman[SUP] 2 3 [/SUP], Lisa Cooper[SUP] 1 2 [/SUP], Nadya Kagansky[SUP] 2 4 [/SUP], Tatiana Nagulevich[SUP] 5 [/SUP], Tamari Snir[SUP] 5 [/SUP], Avital Hershkovitz[SUP] 2 6 [/SUP], Avraham Weiss[SUP] 1 2 [/SUP], Yichayaou Beloosesky[SUP] 1 2 [/SUP], Yaara Leibovici Weissman[SUP] 2 7 [/SUP]
Affiliations
- PMID: 35100607
- DOI: 10.1159/000521412
Abstract
Background/aims: The novel coronavirus SARS-CoV-2 has caused a pandemic threatening millions of people worldwide. This study aimed to describe clinical characteristics, outcomes, and risk factors of SARS-CoV-2-positive, asymptomatic, frail older adults.
Methods: A retrospective cohort study was conducted in 6 designated COVID-19 units, in skilled nursing homes. Subjects were severely frail older adults, positive for SARS-CoV-2, and asymptomatic at the time of their admission in these units. Residents' characteristics and symptoms were obtained via electronic medical records. The primary outcome was a composite of death or hospitalization by day 40. We looked at time to the primary outcome and used Cox regression for a multivariate analysis.
Results: During March-November 2020, 849 residents met inclusion criteria. Median age was 84 years. Most were completely dependent for basic activities of daily living and showed cognitive impairment. Six hundred forty-one (75.5%) residents were discharged after considered cured from COVID-19, 125 (14.7%) were hospitalized, and 82 (9.7%) died in the facilities. In survival analysis, 35% reached the primary outcome of death or hospitalization by day 40. Age (hazard ratio
1.23; 95% confidence interval [CI] 1.1-1.4), male gender (HR 1.41; 95% CI: 1.1-1.88), and COPD (HR 1.8; 95% CI: 1.23-2.67) were significant risk factors.
Conclusions: In this large cohort, we report care and prognosis of asymptomatic older adults with major functional or cognitive impairments during the COVID-19 pandemic. Most presymptomatic patients do not develop severe infection, and age stays a predominant risk factor, even in the frailest older adults.
Keywords: Coronavirus disease; Frailty; Long-term care; Older adults; Vitamin D.