tetano
Editor, Senior Moderator
Intern Med J
. 2021 Mar 16.
doi: 10.1111/imj.15286. Online ahead of print.
Presenting symptoms of COVID-19 and clinical outcomes in hospitalised older adults
Kate Gregorevic[SUP] 1 [/SUP], Andrea Maier[SUP] 2 [/SUP], Roeisa Miranda[SUP] 3 [/SUP], Paula Loveland[SUP] 3 [/SUP], Katherine Miller[SUP] 3 [/SUP], Kirsty Buising[SUP] 4 [/SUP], Caroline Marshall[SUP] 5 [/SUP], Bronwyn O'Gorman[SUP] 3 [/SUP], Amanda Tan[SUP] 3 [/SUP], Kylie Staggard[SUP] 6 [/SUP], Tessa O'Halloran[SUP] 3 [/SUP], Huong Xuan Thi Nguyen[SUP] 6 [/SUP], Jessica Disler[SUP] 3 [/SUP], Frances Crotty[SUP] 3 [/SUP], Kai Lim[SUP] 3 [/SUP], Joseph Cianter[SUP] 3 [/SUP], Cate Kelly[SUP] 7 [/SUP], Kwang Lim[SUP] 8 [/SUP]
Affiliations
Abstract
Background: In July 2020, a Covid-19 outbreak was recognised in the geriatric wards at a subacute campus of the Royal Melbourne Hospital affecting patients and staff. Patients were also admitted to this site after diagnosis in residential care.
Aims: to describe the early symptoms and the outcomes of Covid in older adults.
Methods: Patients diagnosed with COVID-19 at the facility in July or August 2020 were identified and their medical records were examined to identify symptoms present before and after their diagnosis and to determine their outcomes.
Results: Overall, 106 patients were identified with Covid-19 with median age of 84.3 years (range 41-104 years) with 61 diagnosed as hospital inpatients after a median length of stay of 49 days, 31 been transferred from residential aged care facilities with a known diagnosis and 11 were diagnosed after discharge. There were 95 patients included in an analysis of symptom type and timing onset. Overall 61 (64.2%) were asymptomatic at the time of diagnosis of COVID-19, having been diagnosed through screening initiated on site. Of these, 88.6% developed symptoms of COVID-19 within 14 days. The most common initial symptom type was respiratory, but there was wide variation in presentation, including fever, gastrointestinal and neurological symptoms, many initially not recognized as being due to COVID-19. 33/104 patients died within 30 days of diagnosis.
Conclusions: Covid-19 diagnosis is challenging due to the variance in symptoms. In the context of an outbreak, asymptomatic screening can identify affected patients early in the disease course. This article is protected by copyright. All rights reserved.
Keywords: Aged; Cohort study; Coronavirus Infections/ diagnosis; Covid-19; Disease Transmission.
. 2021 Mar 16.
doi: 10.1111/imj.15286. Online ahead of print.
Presenting symptoms of COVID-19 and clinical outcomes in hospitalised older adults
Kate Gregorevic[SUP] 1 [/SUP], Andrea Maier[SUP] 2 [/SUP], Roeisa Miranda[SUP] 3 [/SUP], Paula Loveland[SUP] 3 [/SUP], Katherine Miller[SUP] 3 [/SUP], Kirsty Buising[SUP] 4 [/SUP], Caroline Marshall[SUP] 5 [/SUP], Bronwyn O'Gorman[SUP] 3 [/SUP], Amanda Tan[SUP] 3 [/SUP], Kylie Staggard[SUP] 6 [/SUP], Tessa O'Halloran[SUP] 3 [/SUP], Huong Xuan Thi Nguyen[SUP] 6 [/SUP], Jessica Disler[SUP] 3 [/SUP], Frances Crotty[SUP] 3 [/SUP], Kai Lim[SUP] 3 [/SUP], Joseph Cianter[SUP] 3 [/SUP], Cate Kelly[SUP] 7 [/SUP], Kwang Lim[SUP] 8 [/SUP]
Affiliations
- PMID: 33724644
- DOI: 10.1111/imj.15286
Abstract
Background: In July 2020, a Covid-19 outbreak was recognised in the geriatric wards at a subacute campus of the Royal Melbourne Hospital affecting patients and staff. Patients were also admitted to this site after diagnosis in residential care.
Aims: to describe the early symptoms and the outcomes of Covid in older adults.
Methods: Patients diagnosed with COVID-19 at the facility in July or August 2020 were identified and their medical records were examined to identify symptoms present before and after their diagnosis and to determine their outcomes.
Results: Overall, 106 patients were identified with Covid-19 with median age of 84.3 years (range 41-104 years) with 61 diagnosed as hospital inpatients after a median length of stay of 49 days, 31 been transferred from residential aged care facilities with a known diagnosis and 11 were diagnosed after discharge. There were 95 patients included in an analysis of symptom type and timing onset. Overall 61 (64.2%) were asymptomatic at the time of diagnosis of COVID-19, having been diagnosed through screening initiated on site. Of these, 88.6% developed symptoms of COVID-19 within 14 days. The most common initial symptom type was respiratory, but there was wide variation in presentation, including fever, gastrointestinal and neurological symptoms, many initially not recognized as being due to COVID-19. 33/104 patients died within 30 days of diagnosis.
Conclusions: Covid-19 diagnosis is challenging due to the variance in symptoms. In the context of an outbreak, asymptomatic screening can identify affected patients early in the disease course. This article is protected by copyright. All rights reserved.
Keywords: Aged; Cohort study; Coronavirus Infections/ diagnosis; Covid-19; Disease Transmission.