Key summary points Aim To characterise symptoms, key findings and clinical outcomes in older adults with COVID-19. Findings 12% of older individuals did not present with classical COVID-19 symptoms, though fever, dyspnoea, delirium and raised inflammation were associated with higher mortality. Compared with fitter older individuals, some measures of immune activity were lower in frailer patients. Message COVID-19 may present without cardinal symptoms as well as implicate a possible role for age-related changes in immunity in mediating the relationship between frailty and mortality. Purpose To describe the clinical features of COVID-19 in older adults, and relate these to outcomes. Methods A cohort study of 217 individuals (median age 80, IQR 74–85 years; 62% men) hospitalised with COVID-19, followed up for all-cause mortality, was conducted. Secondary outcomes included cognitive and physical function at discharge. C-reactive protein and neutrophil:lymphocyte ratio were used as measures of immune activity. Results Cardinal COVID-19 symptoms (fever, dyspnoea, cough) were common but not universal. Inflammation on hospitalisation was lower in frail older adults. Fever, dyspnoea, delirium and inflammation were associated with mortality. Delirium at presentation was an independent risk factor for cognitive decline at discharge. Conclusions COVID-19 may present without cardinal symptoms as well as implicate a possible role for age-related changes in immunity in mediating the relationship between frailty and mortality.
【저자키워드】 COVID-19, Mortality, Epidemiology, immune dysfunction, Post-hospitalisation outcomes, 【초록키워드】 Inflammation, Immunity, frailty, C-reactive protein, Symptom, outcome, cough, Symptoms, discharge, immune, cohort study, Clinical outcome, outcomes, Adults, delirium, Fever, hospitalisation, COVID-19 symptoms, patients, clinical feature, Dyspnoea, COVID-19 symptom, cognitive, Older, median age, individual, all-cause mortality, measure, independent risk factor, finding, message, men, hospitalised, physical, secondary, Result, classical, raised, conducted, were used, changes in, individuals, IQR, with COVID-19, 【제목키워드】 Inflammation, frailty, Older, feature,