Background It is increasingly recognised that older patients may not present with typical symptoms of COVID-19. Aims This study aims to evaluate the incidence, characteristics and clinical outcome of older adults with atypical presentations of COVID-19. Methods A 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. Results One 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. Conclusion Older 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.

The COVID-19 pandemic has altered the business world in historic proportions. Whereas the short-term effects have been felt by many, the long-term effects of the pandemic will likely create paradigm shifts of unknown impact. The novelty of this situation has had drastic and potentially lasting organizational effects. We use existing research to explore and presage the effects of these paradigm shifts across multiple domains including: job security, financial consequences, remote work, worker wellbeing, and career attitudes. By exploring the implications in each area of business, the hope is that researchers and practitioners can better prepare for a post-pandemic future.

This study aims to analyze: 1) Transformational leadership influences work motivation on employees of PT Meritindo Sejahtera Jakarta. 2) Job stress influences work motivation on PT Meritindo Sejahtera Jakarta employees. 3) Transformational leadership influencesperformance service of PT Meritindo Sejahtera Jakarta employees. 4) work stress affects theperformance service of PTemployees Merintido Sejahtera Jakarta. 5) work motivation has an effect onperformance service of PT Meritindo Sejahtera Jakarta employees. The research method is: quantitative research that uses the survey method in question is to explain the causal relationships or correlations commonly referred to as path analysis tools with analytical tools using the Lisrel SEM Program 8.8. Respondents were 199 employees at PT Meritindo Sejahtera Jakarta. The results of the study are: 1) the influence of transformational leadership on work motivation of PT Meritindo Sejahtera Jakarta employees. 2) the insignificant influence of work stress on work motivation on employees of PT Meritindo Sejahtera Jakarta. 3) the influence of transformational leadership onperformance service on PT Meritindo Sejahtera employees 4) the influence of work stress onperformance service employeeon PT Meritindo Sejahtera Jakarta employees. 5) the influence of motivation onperformance service on PT Meritindo Sejahtera employees.

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