Abstract
Background: It is increasingly recognised that older patients may not present with typical symptoms of COVID-19.
Aims: This study aims to evaluate the incidence, characteristics and clinical outcome of older adults with atypical presentations of COVID-19.
Methods: A retrospective analysis of adults ≥ 65 years with confirmed COVID-19 admitted to our institution between 1 March and 24 April 2020 was performed. Patients were categorised into typical or atypical groups based on primary presenting complaint in the community.
Results: One hundred twenty-two patients (mean age 81 ± 8 years; 62 male) were included. Seventy-three (60%) were categorised into the typical group and 49 (40%) into the atypical group. In the atypical group, common presenting complaints were fall in 18 (36%), reduced mobility or generalised weakness in 18 (36%) and delirium in 11 (22%). Further assessment by paramedics and on admission found 32 (65%) to have typical features of COVID-19, fever being the most common, and 22 (44%) were hypoxic. This subset had worse outcomes than those in the typical group with a mortality rate of 50% versus 38%, respectively, although this was not statistically significant (P = 0.27). No significant difference in mortality or length of hospital stay between the groups was demonstrated.
Conclusion: Older patients with atypical presentation of COVID-19 in the community are equally susceptible to poor outcomes. Early detection may improve outcomes and limit community transmission. Primary care practitioners should be vigilant and consider prompt onward referral.
Keywords: Atypical symptoms; COVID-19; Coronavirus; Older adults.
【저자키워드】 COVID-19, coronavirus, older adults., Atypical symptoms, 【초록키워드】 Mortality, outcome, Clinical outcome, outcomes, Adults, older patient, Characteristics, delirium, Fever, Early detection, male, Patient, Community, Retrospective analysis, community transmission, age, mortality rate, incidence, group, Admission, Care, paramedics, older patients, Atypical, Hospital stay, Older, significant difference, no significant difference, typical symptoms, weakness, Practitioner, susceptible, feature, limit, hypoxic, generalised weakness, IMPROVE, evaluate, was performed, reduced, demonstrated, subset, statistically significant, presenting, increasingly, typical symptom, 【제목키워드】 Older, hospitalised,