Clinical presentation and mortality in hospitalized patients aged 80+ years with COVID-19–A retrospective cohort study. (May 2021)

• Record Type: Journal Article
• Authors: Karlsson, Linda Katharina; Jakobsen, Lasse Hjort; Hollensberg, Louise; Ryg, Jesper; Midttun, Mette; Frederiksen, Henrik; Glenthøj, Andreas; Kodahl, Anette Raskov; Secher-Johnsen, Joanna; Nielsen, Lene Kongsgaard; Bofill, Nuria Gonzalez; Knudtzen, Fredrikke Christie; Lund, Cecilia Margareta
• Is Part Of: Archives of gerontology and geriatrics. Volume 94(2021)
• Publication Date: 2021-05
• Subjects: Delirium -- Falls -- Frailty -- Multimorbidities -- SARS-CoV-2; Aging -- Periodicals; Geriatrics -- Periodicals; Gerontology -- Periodicals; Electronic journals; 305.26
• DOI: 10.1016/j.archger.2020.104335
• Languages: English
• ISSNs: 0167-4943

Abstract

Highlights: Older patients with SARS-Cov-2 also display classical symptoms of COVID-19. Many older patients with Covid-19 displayed geriatric frailty symptoms. Overall 30-day-mortality was 41%. High mortality for nursing homes residents and patients with falls and confusion. Abstract: Background: COVID-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has great health implications in older patients, including high mortality. In general, older patients often have atypical symptom presentations during acute illness due to a high level of comorbidity. The purpose of this study was to investigate the presentation of symptoms at hospital admissions in older patients with COVID-19 and evaluate its impact on disease outcome. Methods: This retrospective study included patients ≥80 years of age with a positive test for SARS-CoV-2, who were admitted to one of three medical departments in Denmark from March 1st to June 1st, 2020. Results: A total of 102 patients (47% male) with a mean age of 85 years were included. The most common symptoms at admission were fever (74%), cough (62%), and shortness of breath (54%). Furthermore, atypical symptoms like confusion (29%), difficulty walking (13%), and falls (8%) were also present. In-hospital and 30-day mortality were 31% ( n = 32) and 41% ( n = 42), respectively. Mortality was highest in patients with confusion (50% vs 38%) or falls (63% vs 39%), and nursing home residency prior to hospital admission was associated with higher mortality (OR 2.7, 95% CI 1.1–6.7). Conclusions: Older patients with SARS-Cov-2 displayed classical symptoms of COVID-19 but also geriatric frailty symptoms such as confusion and walking impairments. Additionally, both in-hospital and 30-day mortality was very high. Our study highlights the need for preventive efforts to keep older people from getting COVID-19 and increased awareness of frailty among those with COVID-19.