• Olde Rikkert M G M MGM Radboudumc, afd. Geriatrie, Nijmegen. Contact: M. G.M. Olde Rikkert (Marcel.OldeR, R W Vingerhoets, N van Geldorp, E de Jong, and H A A M Maas.
• Radboudumc, afd. Geriatrie, Nijmegen.
• Ned Tijdschr Geneeskd. 2020 Apr 8; 164.

AbstractClinical characteristics and outcomes among older patients with a SARS-CoV-2 infection differ greatly from those seen in younger patients. Here we highlight atypical presentations of this fulminant infectious disease COVID-19, based on a clinical case and a cohort of 19 patients admitted to a geriatric ward. The degree of frailty, resilience and number of co-morbidities caused COVID-19 to present as acute geriatric syndrome events such as falls, delirium and dehydration in these patients. Clinical laboratory results considered typical for COVID-19 were present less often in this frail older population. As in other countries, morbidity and mortality is most severe among frail male patients; therefore, assessment of changes suggestive of typical acute geriatric syndromes in frail older patients with chronic diseases should lead to a careful clinical examination for a SARS-CoV-2 infection. Protocols for diagnosis, and contact isolation measures, should take these atypical presentations into account.

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