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

• Published in: Archives of gerontology and geriatrics Vol. 94; p. 104335
• Main 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
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.05.2021
• Subjects: Aged; Aged, 80 and over; Comorbidity; COVID-19; Delirium; Falls; Female; Frailty; Frailty - epidemiology; Hospitalization; Humans; Male; Multimorbidities; Retrospective Studies; SARS-CoV-2; Delirium; Falls; Frailty; SARS-CoV-2; Multimorbidities
• ISSN: 0167-4943; 1872-6976
• DOI: 10.1016/j.archger.2020.104335

•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. 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. 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. 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). 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.