• Jasmine Ming Gan, Jason Kho, Michelle Akhunbay-Fudge, Hwei Ming Choo, Melanie Wright, Farzana Batt, Mandal Amit K J AKJ http://orcid.org/0000-0003-0986-5927 Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Wexham Str, Rahul Chauhan, and Constantinos G Missouris.
• Department of Medicine, Wexham Park Hospital, Frimley Health NHS Foundation Trust, Wexham Street, Slough, UK.
• Ir J Med Sci. 2021 May 1; 190 (2): 469-474.

BackgroundIt is increasingly recognised that older patients may not present with typical symptoms of COVID-19.AimsThis study aims to evaluate the incidence, characteristics and clinical outcome of older adults with atypical presentations of COVID-19.MethodsA 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.ResultsOne 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.ConclusionOlder 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.

16 keywords...

hide…