Falls as One of the Atypical Presentations of COVID-19 in Older Population

Abstract

Introduction: Studies revealed COVID-19 atypical symptoms such as falls, delirium, confusion, dizziness, unusual fatigue in older patients. Falls in the older population and their consequences are one of the leading causes of disability; they significantly reduce the quality of life and lead to loss of independence and impaired social functioning. The aim of this study is to present the possible correlation between COVID-19 and diseases of the musculoskeletal system, in particular the occurrence of fall-related injuries. Significance: This article highlights the importance of falls as one of the atypical symptoms of COVID-19 infection in older adults, which is not directly associated with infection and could be misinterpreted. Methods: The conducted meta-analysis is based on a review of the scientific literature available in English, French, Dutch, Polish in the PubMed/MEDLINE, Cochrane Library, Embase, Scopus, PEDro, GBL databases from December 1, 2019 to July 30, 2020, covering Clinical Trial, Randomized Controlled Trial, Meta-Analysis, Systematic Reviews and Case Reports. The following keywords were taken into account: fall, (hip/pertrochanteric/proximal femur) fracture, aged and COVID-19. Twenty-seven references were accepted for final analysis. Results: It was found that symptoms such as falls observed in the older adults can be associated with COVID-19 infection. Falls and slips are also the most common mechanism for hip fracture during the pandemic outbreak. Conclusions: According to authors of this study, atypical presentations of COVID-19 should be considered when screening and testing the people at increased risk due to their age. However, further prospective studies are urgently needed to investigate the possible correlation between COVID-19 and falls in older adults.

Factors Associated With COVID-19 Hospitalizations and Deaths in French Nursing Homes

“…In line with the literature, 8,23,30 older age and comorbidities were significantly associated with death in our study. Falls are an atypical symptom of COVID-19, 14,31 and our study is the first to show an association between falls and hospitalization of NH residents with confirmed or suspected COVID-19. Unlike the literature, 32 we found that polymedication was a protective factor against death.…”

Injury-Related Emergency Department Visits During the COVID-19 Pandemic

“…For falls-related injuries, many studies have reported syncope or nonmechanical falls as a presenting feature in patients with COVID-19, particularly among older adult patients. [18][19][20] This may result in an increase in falls-related visits to the ED among the older adult population throughout the pandemic. However, this study found that falls-related ED visits overall dropped in the beginning of the pandemic and did not see any significant increase in falls among older populations aged ≥60 years.…”

Clinical Manifestations of COVID-19 in the Feet: A Review of Reviews

“…Guillain-Barré Syndrome is an acute polyradiculopathy characterized by rapidly progressive symmetrical limb weakness, areflexia, sensory symptoms and, in some patients, facial weakness [31]. These neurological symptoms in lower limbs, muscle weakness, and reduced reflexes, all associated with the presence of COVID-19, can lead to and increase the risk of falls in older people suffering from them, with falls in the elderly being considered another complication of neurological origin or even described as a nonspecific symptom of COVID-19 [32]. On the other hand, there are authors who claim that the neuroinvasion capacity of the SARS-CoV-2 virus and its capacity to develop neurological complications [7] is yet to be determined.…”