Atypical presentations in the hospitalised older adult testing positive for SARS-CoV-2: a retrospective observational study in Glasgow, Scotland. Issue 2 (May 2021)

• Record Type: Journal Article
• Authors: Davis, Peter; Gibson, Rory; Wright, Emily; Bryan, Amy; Ingram, Jamie; Lee, Ren Ping; Godwin, Jon; Evans, Tom; Burleigh, Elizabeth; Wishart, Steven; Capek, Eileen; Mitchell, Lara
• Is Part Of: Scottish medical journal. Volume 66:Issue 2(2021)
• Page Start: 89
• Page End: 97
• Publication Date: 2021-05
• Subjects: Severe Acute Respiratory Syndrome Coronavirus 2, Coronavirus Disease 2019 -- delirium -- prognostic indicators -- older people; Medicine -- Periodicals; 610.5
• DOI: 10.1177/0036933020962891
• Languages: English
• ISSNs: 0036-9330

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.