Clinical Features and Outcomes of COVID-19 in Older Adults: A Systematic Review and Meta-Analysis

Singhal, Sunny; Kumar, Pramod; Singh, Sumitabh; Saha, Srishti; Dey, Aparajit Ballav

doi:10.21203/rs.3.rs-38971/v1

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…60 years and over. The higher risk of death in men and older adults is similar to global trends [ 40 , 41 ]. Apart from the higher contribution of men to comorbidities, other suggested reasons for their higher morbidity and mortality include behavioral, social and biological differences that favor women [ 40 ].…”

Section: Discussionmentioning

confidence: 75%

Outcomes of COVID-19 patients with comorbidities in southwest Nigeria

et al. 2021

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Background Data on the comorbidities that result in negative outcomes for people with COVID-19 are currently scarce for African populations. This study identifies comorbidities that predict death among a large sample of COVID-19 patients from Nigeria. Methods This was a retrospective analysis of medical records for 2184 laboratory confirmed cases of COVID-19 in Lagos, southwest Nigeria. Extracted data included age, sex, severity of condition at presentation and self-reported comorbidities. The outcomes of interest were death or discharge from facility. Results Most of the cases were male (65.8%) and the median age was 43 years (IQR: 33–55). Four hundred and ninety-two patients (22.5%) had at least one comorbidity and the most common amongst them were hypertension (74.2%) and diabetes (30.3%). The mortality rate was 3.3% and a significantly higher proportion of patients with comorbidities died compared to those with none. The comorbidities that predicted death were hypertension (OR: 2.21, 95%CI: 1.22–4.01), diabetes (OR: 3.69, 95% CI: 1.99–6.85), renal disease (OR: 12.53, 95%CI: 1.97–79.56), cancer (OR: 14.12, 95% CI: 2.03–98.19) and HIV (OR: 1.77–84.15]. Conclusion Comorbidities are prevalent and the associated risk of death is high among COVID-19 patients in Lagos, Nigeria. Public enlightenment, early identification and targeted care for COVID-19 cases with comorbidities are recommended as the pandemic evolves.

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Section: Discussionmentioning

confidence: 75%

Outcomes of COVID-19 patients with comorbidities in southwest Nigeria

et al. 2021

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“…Most of the published studies examined the clinical features and outcomes of COVID‐19 in older adults. Current research mainly focused on the immediate and more pressing issues, such as the physiological presentations of COVID‐19 for older adults (Gan et al, 2020; Liu et al, 2020; Neumann‐Podczaska et al, 2020; Singhal et al, 2020). In comparison, literature about long‐term mental health issues of socially isolated older adults in COVID‐19 is relatively limited.…”

Section: Introductionmentioning

confidence: 99%

Psychological impacts and online interventions of social isolation amongst older adults during COVID‐19 pandemic: A scoping review

Rodrigues

Han

et al. 2021

Journal of Advanced Nursing

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Aim To summarise the psychological impacts of social isolation amongst older adults during COVID‐19 and review the benefits and limitations of online interventions used to combat social isolation. Design A scoping review was performed. Data Sources A systematic search was performed from October 2020 to January 2021 in seven electronic databases: China National Knowledge Infrastructure (CNKI), PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, Cochrane Library and Web of Science. A hand search of the reference lists of included papers and WHO publications was performed. Grey literature search was carried out from Scopus, ProQuest Dissertation and Google Scholar. Review Methods Studies were screened, appraised and extracted independently by two reviewers. Thematic analysis was used to synthesise data, which were presented in a descriptive manner and organised into categories and themes. Results Totally, 33 studies were included. Four themes and eight sub‐themes emerged: (1) negative impacts and experiences of older adults during social isolation, (2) adopting coping behaviours in the midst of COVID‐19, (3) online interventions to combat the consequences of social isolation, (4) barriers to online intervention. Conclusion The COVID‐19 pandemic has taken an emotional toll on older adults’ psychological wellbeing and has highlighted the untapped strengths of older adults facing isolation. Online interventions, which could be a new normal in the COVID era, were beneficial in combating social isolation. Strategies by various stakeholders were recommended to tackle the barriers of online interventions. Impact With the COVID‐19 pandemic still in progress, this review provides insights on the psychological impacts of social isolation amongst older adults. Nurses in the community and long‐term care facilities could adopt strategies and online intervention to better support the older adults, contribute to a stronger COVID‐19 response and support system, and an overall better road to recovery from this crisis.

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“…As well as being at increased risk for symptomatic infections, it is apparent that older adults are at higher risk for mortality; the overall COVID‐19 mortality is reported to be 1.38%, rising sharply with age to 13.4% for those aged over 80 years, 15 with mortality rising to over 30% for those who are living with frailty 16 . In one meta‐analysis, it was reported that approximately half of all people over 60 years of age with COVID‐19 will experience a severe disease course, although the majority of included studies were based on cohorts admitted to hospital for COVID‐19 and thus likely do not represent the breadth of community cases 17 …”

Section: Introductionmentioning

confidence: 99%

Presenting symptoms of COVID‐19 and clinical outcomes in hospitalised older adults

Gregorevic

Maier

Miranda

et al. 2021

Internal Medicine Journal

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Background In July 2020, a COVID‐19 outbreak was recognised in the geriatric wards at a subacute campus of the Royal Melbourne Hospital affecting patients and staff. Patients were also admitted to this site after diagnosis in residential care. Aims To describe the early symptoms and the outcomes of COVID‐19 in older adults. Methods Patients diagnosed with COVID‐19 at the facility in July or August 2020 were identified and their medical records were examined to identify symptoms present before and after their diagnosis and to determine their outcomes. Results Overall, 106 patients were identified as having COVID‐19, with median age of 84.3 years (range 41–104 years); 64 were diagnosed as hospital inpatients after a median length of stay of 49 days, 31 were transferred from residential aged care facilities with a known diagnosis and 11 were diagnosed after discharge. There were 95 patients included in an analysis of symptom type and timing onset. Overall, 61 (64.2%) were asymptomatic at the time of diagnosis of COVID‐19, having been diagnosed through screening initiated on site. Of these, 88.6% developed symptoms of COVID‐19 within 14 days. The most common initial symptom type was respiratory, but there was wide variation in presentation, including fever, gastrointestinal and neurological symptoms, many initially not recognised as being due to COVID‐19. Of 104 patients, 32 died within 30 days of diagnosis. Conclusions COVID‐19 diagnosis is challenging due to the variance in symptoms. In the context of an outbreak, asymptomatic screening can identify affected patients early in the disease course.

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Clinical Features and Outcomes of COVID-19 in Older Adults: A Systematic Review and Meta-Analysis

Cited by 4 publications

References 23 publications

Outcomes of COVID-19 patients with comorbidities in southwest Nigeria

Outcomes of COVID-19 patients with comorbidities in southwest Nigeria

Psychological impacts and online interventions of social isolation amongst older adults during COVID‐19 pandemic: A scoping review

Presenting symptoms of COVID‐19 and clinical outcomes in hospitalised older adults

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