Purpose
To ascertain delirium prevalence and outcomes in COVID-19.
Methods
We conducted a point-prevalence study in a cohort of COVID-19 inpatients at University College Hospital. Delirium was defined by DSM-IV criteria. The primary outcome was all-cause mortality at 4 weeks; secondary outcomes were physical and cognitive function.
Results
In 71 patients (mean age 61, 75% men), 31 (42%) had delirium, of which only 12 (39%) had been recognised by the clinical team. At 4 weeks, 20 (28%) had died, 26 (36%) were interviewed by telephone and 21 (30%) remained as inpatients. Physical function was substantially worse in people after delirium − 50 out of 166 points (95% CI − 83 to − 17, p = 0.01). Mean cognitive scores at follow-up were similar and delirium was not associated with mortality in this sample.
Conclusions
Our findings indicate that delirium is common, yet under-recognised. Delirium is associated with functional impairments in the medium term.
Purpose
Our aim was to quantify the mortality from COVID-19 and identify any interactions with frailty and other demographic factors.
Methods
Hospitalised patients aged ≥ 70 were included, comparing COVID-19 cases with non-COVID-19 controls admitted over the same period. Frailty was prospectively measured and mortality ascertained through linkage with national and local statutory reports.
Results
In 217 COVID-19 cases and 160 controls, older age and South Asian ethnicity, though not socioeconomic position, were associated with higher mortality. For frailty, differences in effect size were evident between cases (HR 1.02, 95% CI 0.93–1.12) and controls (HR 1.99, 95% CI 1.46–2.72), with an interaction term (HR 0.51, 95% CI 0.37–0.71) in multivariable models.
Conclusions
Our findings suggest that (1) frailty is not a good discriminator of prognosis in COVID-19 and (2) pathways to mortality may differ in fitter compared with frailer older patients.
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 ascertain delirium prevalence and outcomes in COVID-19.
Methods
We conducted a point-prevalence study in a cohort of COVID-19 inpatients at University College Hospital. Delirium was defined by DSM-IV criteria. The primary outcome was all-cause mortality at 4 weeks; secondary outcomes were physical and cognitive function.
Results
In 71 patients, 31 (42%) had delirium, of which only 19 had been recognised by the clinical team. At 4 weeks, 20 (28%) had died, 26 (36%) were interviewed by telephone and 21 (30%) remained as inpatients. Physical function was substantially worse in people after delirium (-39 points on functional scale/166, 95% CI -92 to -21, p=0.01) (Table 2). Mean cognitive scores at follow-up were similar and delirium was not associated with mortality in this sample.
Conclusions
Our findings indicate that delirium is common, yet under-recognised. Delirium is associated with functional impairments in the medium-term.
Purpose
To describe the clinical features of COVID-19 in older adults, and relate these to outcomes.
Methods
Cohort study of 217 individuals (≥70 years) hospitalised with COVID-19, followed up for allcause
mortality. 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 agerelated
changes in immunity in mediating the relationship between frailty and mortality.
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