Atypical presentation of COVID-19 in a frail older person

Tay, H S; Harwood, Rowan H.

doi:10.1093/ageing/afaa068

Cited by 88 publications

(100 citation statements)

References 2 publications

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“…5,13 Atypical presentations of COVID-19 have also been reported in elderly frail patients and in other solid organ transplant recipients. 15,16 Highlighting, that in the present era constant vigilance is needed to minimize the spread of in the healthcare environment between patients and healthcare providers.…”

Section: Discussionmentioning

confidence: 99%

Low prevalence and disease severity of COVID‐19 in post‐liver transplant recipients—A single centre experience

Verma

Khorsandi

Dolcet

et al. 2020

Liver International

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Section: Discussionmentioning

confidence: 99%

Low prevalence and disease severity of COVID‐19 in post‐liver transplant recipients—A single centre experience

Verma

Khorsandi

Dolcet

et al. 2020

Liver International

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“…Immune dysfunction and severity of inflammation are other reasons for increased mortality in COVID-19 patients (2,16,44). Antibody-dependent enhancement (ADE) due to cross-reactive antibodies produced in the course of previous infections by other viruses may be a possible cause for this phenomenon (45).…”

Section: Covid-19 Mortality In Geriatric Populationmentioning

confidence: 99%

Geriatric Population During the COVID-19 Pandemic: Problems, Considerations, Exigencies, and Beyond

Dhama

Patel

Kumar

et al. 2020

Front. Public Health

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The coronavirus disease 2019 (COVID-19) pandemic wreaked havoc worldwide, with more than 20 million confirmed cases and nearly 0. 75 million deaths as of 10th August 2020. Various factors determine the severity and symptoms of this infection. Older age and underlying diseases are the challenges being faced in controlling and treating COVID-19. In 2019, 703 million of the global population was older than 65 years of age. The estimated mortality due to COVID-19 in people older than 76 years of age is reportedly 18%. Frequent infections in older people, higher disease severity, and increased mortality are major challenges in the implementation of appropriate preventive measures and future strategies to protect against this disease in geriatric population. Poor health status, weak immune function, lowered organ function, increased probability of multiple underlying diseases, and poor attention to personal health can increase the susceptibility to various diseases in the geriatric population. Concerning inadequate immunity, the decrease expression of receptors and exaggerated pathophysiologic responses can be debilitating. However, future studies will reveal the hidden facets in these aspects in this COVID-19 catastrophe. In this article, we reviewed the main concerns of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the geriatric population, including the risk of acquiring severe COVID-19 resulting in mortality, variation in clinical manifestations, and other pandemic-related concerns. We also discussed the need for increasing attention toward the elderly, taking appropriate prevention and control measures, and considering geriatric-related adjustments in vaccine design and development.

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“…The older population has been particularly vulnerable to SARS-CoV-2 infection, frequently developing severe forms of COVID-19 with high mortality [11,12]. In spite of this epidemiology, at the moment of writing the association of COVID-19 with delirium has been investigated only sporadically [13], with some anecdotal reports of patients presenting delirium as the first, and sometimes only, sign of COVID-19 [8,14,15]. Thus, the incidence and clinical correlations of delirium during hospital stay for COVID-19 are still poorly known.…”

Section: Introductionmentioning

confidence: 99%

Delirium in COVID-19: epidemiology and clinical correlations in a large group of patients admitted to an academic hospital

et al. 2020

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Background Delirium incidence and clinical correlates in coronavirus disease-19 (COVID-19) pneumonia are still poorly investigated. Aim To describe the epidemiology of delirium in patients hospitalized for suspect COVID-19 pneumonia during the pandemic peak in an academic hospital of Northern Italy, identify its clinical correlations and evaluate the association with mortality. Methods The clinical records of 852 patients admitted for suspect COVID-19 pneumonia, defined as respiratory symptoms or fever or certain history of contact with COVID-19 patients, plus chest CT imaging compatible with alveolar-interstitial pneumonia, were retrospectively analyzed. Delirium was defined after careful revision of daily clinical reports in accordance with the Confusion Assessment Method criteria. Data on age, clinical presentation, comorbidities, drugs, baseline lab tests and outcome were collected. The factors associated with delirium, and the association of delirium with mortality, were evaluated through binary logistic regression models. Results Ninety-four patients (11%) developed delirium during stay. They were older (median age 82, interquartile range, IQR 78–89, vs 75, IQR 63–84, p < 0.001), had more neuropsychiatric comorbidities and worse respiratory exchanges at baseline. At multivariate models, delirium was independently and positively associated with age [odds ratio (OR) 1.093, 95% confidence interval (CI) 1.046–1.143, p < 0.001], use of antipsychotic drugs (OR 4.529, 95% CI 1.204–17.027, p = 0.025), serum urea and lactate-dehydrogenase at admission. Despite a higher mortality in patients with delirium (57% vs 30%), this association was not independent of age and respiratory parameters. Conclusions Delirium represents a common complication of COVID-19 and a marker of severe disease course, especially in older patients with neuropsychiatric comorbidity.

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Atypical presentation of COVID-19 in a frail older person

Cited by 88 publications

References 2 publications

Low prevalence and disease severity of COVID‐19 in post‐liver transplant recipients—A single centre experience

Low prevalence and disease severity of COVID‐19 in post‐liver transplant recipients—A single centre experience

Geriatric Population During the COVID-19 Pandemic: Problems, Considerations, Exigencies, and Beyond

Delirium in COVID-19: epidemiology and clinical correlations in a large group of patients admitted to an academic hospital

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