tetano
Editor, Senior Moderator
Scott Med J
. 2020 Oct 11;36933020962891.
doi: 10.1177/0036933020962891. Online ahead of print.
Atypical presentations in the hospitalised older adult testing positive for SARS-CoV-2: a retrospective observational study in Glasgow, Scotland
Peter Davis[SUP] 1 [/SUP], Rory Gibson[SUP] 1 [/SUP], Emily Wright[SUP] 1 [/SUP], Amy Bryan[SUP] 1 [/SUP], Jamie Ingram[SUP] 1 [/SUP], Ren Ping Lee[SUP] 1 [/SUP], Jon Godwin[SUP] 2 [/SUP], Tom Evans[SUP] 3 [/SUP], Elizabeth Burleigh[SUP] 4 [/SUP], Steven Wishart[SUP] 4 [/SUP], Eileen Capek[SUP] 4 [/SUP], Lara Mitchell[SUP] 4 [/SUP]
Affiliations
Abstract
Introduction: Understanding of how SARS-CoV-2 manifests itself in older adults was unknown at the outset of the pandemic. We undertook a retrospective observational analysis of all patients admitted to older people's services with confirmed COVID-19 in one of the largest hospitals in Europe. We detail presenting symptoms, prognostic features and vulnerability to nosocomial spread. Methods: We retrospectively collected data for each patient with a positive SARSCoV-2 RT PCR between 18th March and the 20th April 2020 in a department of medicine for the elderly in Glasgow. Results: 222 patients were included in our analysis. Age ranged from 56 to 99 years (mean = 82) and 148 were female (67%). 119 patients had a positive swab for SARS-CoV-2 within the first 14 days of admission, only 32% of these patients presented with primarily a respiratory type illness. 103 patients (46%) tested positive after 14 days of admission - this was felt to represent likely nosocomial infection. 95 patients (43%) died by day 30 after diagnosis. Discussion: This data indicates that older people were more likely to present with non-respiratory symptoms. High clinical frailty scores, severe lymphopenia and cumulative comorbidities were associated with higher mortality rates. Several contributing factors will have led to nosocomial transmission.
Keywords: Severe Acute Respiratory Syndrome Coronavirus 2, Coronavirus Disease 2019; delirium; older people; prognostic indicators.
. 2020 Oct 11;36933020962891.
doi: 10.1177/0036933020962891. Online ahead of print.
Atypical presentations in the hospitalised older adult testing positive for SARS-CoV-2: a retrospective observational study in Glasgow, Scotland
Peter Davis[SUP] 1 [/SUP], Rory Gibson[SUP] 1 [/SUP], Emily Wright[SUP] 1 [/SUP], Amy Bryan[SUP] 1 [/SUP], Jamie Ingram[SUP] 1 [/SUP], Ren Ping Lee[SUP] 1 [/SUP], Jon Godwin[SUP] 2 [/SUP], Tom Evans[SUP] 3 [/SUP], Elizabeth Burleigh[SUP] 4 [/SUP], Steven Wishart[SUP] 4 [/SUP], Eileen Capek[SUP] 4 [/SUP], Lara Mitchell[SUP] 4 [/SUP]
Affiliations
- PMID: 33043852
- DOI: 10.1177/0036933020962891
Abstract
Introduction: Understanding of how SARS-CoV-2 manifests itself in older adults was unknown at the outset of the pandemic. We undertook a retrospective observational analysis of all patients admitted to older people's services with confirmed COVID-19 in one of the largest hospitals in Europe. We detail presenting symptoms, prognostic features and vulnerability to nosocomial spread. Methods: We retrospectively collected data for each patient with a positive SARSCoV-2 RT PCR between 18th March and the 20th April 2020 in a department of medicine for the elderly in Glasgow. Results: 222 patients were included in our analysis. Age ranged from 56 to 99 years (mean = 82) and 148 were female (67%). 119 patients had a positive swab for SARS-CoV-2 within the first 14 days of admission, only 32% of these patients presented with primarily a respiratory type illness. 103 patients (46%) tested positive after 14 days of admission - this was felt to represent likely nosocomial infection. 95 patients (43%) died by day 30 after diagnosis. Discussion: This data indicates that older people were more likely to present with non-respiratory symptoms. High clinical frailty scores, severe lymphopenia and cumulative comorbidities were associated with higher mortality rates. Several contributing factors will have led to nosocomial transmission.
Keywords: Severe Acute Respiratory Syndrome Coronavirus 2, Coronavirus Disease 2019; delirium; older people; prognostic indicators.