Failing the frail: The need to broaden the COVID-19 case definition for geriatric patients

Hunt, Clare; Olcott, Flora; Williams, George; Chan, Terrence

doi:10.7861/clinmed.2021-0308

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…Falls were referred to in 16 studies, of which 12 had a cohort design. In these cohort studies, the prevalence was 16.78 ± 9.45, ranging from 3.8 to 36% [8, 9, 28, 33, 34, 36–40, 42, 47].…”

Section: Resultsmentioning

confidence: 99%

“…Twelve studies reported the prevalence of older adults with atypical presentations, which was 29 ± 18.45%, ranging from 7.96 to 73.9% (Table 2) [16, 28, 31, 33–35, 38, 43, 47, 79, 80, 82].…”

Section: Resultsmentioning

confidence: 99%

“…Delirium was the most frequent geriatric syndrome presented in case studies and cohort studies (n = 23 studies) (Table 2). Among the cohort studies (n = 17), 16 reported the percentage of delirium with a prevalence of 37.1 ± 18.16%, ranging from 9.1 to 67.1% [8,9,16,31,32,34,[37][38][39][40][42][43][44][45][46][47]. Anorexia (noted in 2 case studies and 7 cohort studies) had a prevalence of 27.25 ± 22.63%, ranging from 2.1 to 61.3% [8,9,28,30,36,42,48].…”

Section: Atypical Presentations Of Covid-19mentioning

confidence: 99%

See 2 more Smart Citations

Atypical Presentation of COVID-19 in Older Adults: A Scoping Review

Tavares,

Figueiredo,

Passos

et al. 2023

Port J Public Health

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Background: COVID-19 has currently well-described signs and symptoms. However, older adults often present with an atypical condition, which can confuse and delay diagnosis and treatment. Summary: A scoping review was performed according to Joanna Briggs Institute methodology and prepared using the PRISMA-ScR. It included 61 studies. The objectives were to identify the atypical symptoms of COVID-19 in older adults and summarize and synthesize the evidence regarding the clinical outcomes of older adults with atypical presentations of COVID-19. Fifty-eight atypical symptoms were identified. Geriatric syndromes were the most prevalent atypical presentations of COVID-19. The prevalence of older adults with atypical presentation was 29 ± 18.45%. The mortality rate of older adults with atypical presentation was 28.3 ± 10.26 (17–37%). Key Messages: This scoping review showed that geriatric syndromes represent a frequent atypical presentation of COVID-19 in older adults. It is necessary to give visibility to those presentations in older populations with COVID-19 to advance the required interventions.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Atypical Presentations Of Covid-19mentioning

confidence: 99%

See 1 more Smart Citation

Atypical Presentation of COVID-19 in Older Adults: A Scoping Review

Tavares,

Figueiredo,

Passos

et al. 2023

Port J Public Health

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Post-acute sequelae of SARS-CoV-2 infection (Long COVID) in older adults

Russell,

Parker,

Lehoczki

et al. 2024

GeroScience

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Extremes of baseline cognitive function determine the severity of delirium: a population study

Tsui

Yeo

Searle

et al. 2023

Brain

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Though delirium is a significant clinical and public health problem, little is understood about how specific vulnerabilities underlie the severity of its presentation. Our objective was to quantify the relationship between baseline cognition and subsequent delirium severity. We prospectively investigated a population-representative sample of 1510 individuals aged ≥70 years, of whom 209 (13.6%) were hospitalised across 371 episodes (1,999 person-days assessment). Baseline cognitive function was assessed using the modified Telephone Interview for Cognitive Status, supplemented by verbal fluency measures. We estimated the relationship between baseline cognition and delirium severity (Memorial Delirium Assessment Scale, MDAS) and abnormal arousal (Observational Scale for Level of Arousal), adjusted by age, sex, frailty and illness severity. We conducted further analyses examining presentations to specific hospital settings and common precipitating aetiologies. The median time from baseline cognitive assessment to admission was 289 days (interquartile range 130 to 47 days). In admitted patients, delirium was present on at least one day in 45% of admission episodes. The average number of days with delirium (consecutively positive assessments) was 3.9 days. Elective admissions accounted for 88 bed-days (4.4%). In emergency (but not elective) admissions, we found a non-linear U-shaped relationship between baseline global cognition and delirium severity using restricted cubic splines. Participants with baseline cognition two standard deviations (SD) below average (z-score = -2) had a mean MDAS score of 14 points (95% CI 10 to 19). Similarly, those with baseline cognition z-score = +2 had a mean MDAS score of 7.9 points (95% CI 4.9 to 11). Individuals with average baseline cognition had the lowest MDAS scores. The association between baseline cognition and abnormal arousal followed a comparable pattern. C-reactive protein ≥20 mg/L and serum sodium <125 mM/L were associated with more severe delirium. Baseline cognition is a critical determinant of the severity of delirium and associated changes in arousal. Emergency admissions with lowest and highest baseline cognition who develop delirium should receive enhanced clinical attention.

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Failing the frail: The need to broaden the COVID-19 case definition for geriatric patients

Cited by 3 publications

References 12 publications

Atypical Presentation of COVID-19 in Older Adults: A Scoping Review

Atypical Presentation of COVID-19 in Older Adults: A Scoping Review

Post-acute sequelae of SARS-CoV-2 infection (Long COVID) in older adults

Extremes of baseline cognitive function determine the severity of delirium: a population study

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