COVID-19 patients with increasing age experience differential time to initial medical care and severity of symptoms

Abstract

We conducted a retrospective observational study in patients with laboratory-confirmed coronavirus disease (COVID-19) who received medical care in 688 COVID-19 ambulatory units and hospitals in Mexico City between 24 February 2020 and 24 December 2020, to study if the elderly seek medical care later than younger patients and their severity of symptoms at initial medical evaluation. Patients were categorised into eight groups (<20, 20–29, 30–39, 40–49, 50–59, 60–69, 70–79 and ≥80 years). Symptoms at initial evaluation were classified according to a previously validated classification into respiratory and non-respiratory symptoms. Comparisons between time from symptom onset to medical care for every age category were performed through variance analyses. Logistic regression models were applied to determine the risk of presenting symptoms of severity according to age, and mortality risk according to delays in medical care. In total, 286 020 patients were included (mean age: 42.8, s.d.: 16.8 years; 50.4% were women). Mean time from symptom onset to medical care was 4.04 (s.d.: 3.6) days and increased with older age categories (P < 0.0001). Mortality risk increased by 6.4% for each day of delay in medical care from symptom onset. The risk of presenting with the symptoms of severity was greater with increasing age categories. In conclusion, COVID-19 patients with increasing ages tend to seek medical care later, with higher rates of symptoms of severity at initial presentation in both ambulatory units and hospitals.

Comparative analysis of symptom profile and risk of death associated with infection by SARS‐CoV‐2 and its variants in Hong Kong

“…Third, symptom‐based predictions for death are possible, which guides infection prevention of COVID‐19 in residential care homes for the elderly (RCHEs). Though a major surge of severe illnesses in RCHEs may be unlikely under a high vaccine or infection coverage, 32 the delay in seeking medical care among the elderly, 33 the multifold increase in mortality among institutionalized elderly, 34 and the highest number of incidents attributable to RCHEs in the continual recurrent epidemics 7 altogether suggest active syndromic surveillance is needed in RCHEs. Symptoms predictive of severe clinical outcomes can enrich the frailty screening on aged COVID‐19 cases to enable early risk stratification 35 .…”

Factors associated with adverse outcome among hospitalized patients with moderate to severe COVID-19

“…В исследовании Mancilla-Galindo J и соавт. (2021) риск смертности увеличивался на 6,4 % в каждый день отсрочки обращения за медицинской помощью с момента появления симптомов (ОШ 1,06; 95 % ДИ 1,06-1,07; P<0,0001) [12]. В метаанализе 32 исследований с участием 203 250 пациентов показано, что пациенты пожилого возраста имеют повышенный риск смертности от коронавируса, а объединённое отношение шансов и отношение рисков составили 2,61 (95 % ДИ 1,75-3,47) и 1,31 (95 % ДИ 1,11-1,51) соответственно [13].…”

Preoperative atelectasis in patients with obesity undergoing bariatric surgery: a cross-sectional study

“…American Society of Anesthesiologists (ASA) recommendations for elective surgeries included that patients were tested against SARS-CoV-2, screened for symptoms of COVID-19, and advised against surgery when symptoms were present. 17 Rapid antigen tests against SARS-CoV-2 were not yet available in Mexico 18 and it was not feasible to perform RT-PCR on patients before surgery due to long waiting times until the result was available. Thus, the hospital committee decided that patients were screened for COVID-19 by a sequential approach consisting of 1) patients were asked for sign and symptoms of COVID-19 prior to arriving to the hospital and advised not to present for surgery if these were present, 2) upon arrival at the hospital, a rapid SARS-CoV-2 antibody testing was performed.…”