National French Survey of Coronavirus Disease (COVID-19) Symptoms in People Aged 70 and Over

Annweiler, Cédric; Sacco, Guillaume; Salles, Nathalie; Aquino, Jean-Pierre; Gautier, Jennifer; Berrut, Gilles; Guérin, Olivier; Gavazzi, G.

doi:10.1093/cid/ciaa792

Cited by 73 publications

(94 citation statements)

References 12 publications

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“…On the other hand, confusion stands out as a symptom present in 11% of our sample. Gutiérrez-Rodríguez et al and Annweiler et al (11,17) reported frequencies similar to ours in the subgroup of patients 80 years or older. These ndings are in line with those observed in the majority of diseases of this population (including infections), in which less symptomatic or atypical presentations are more frequently observed (3)(4)(5).…”

Section: Clinical Presentationsupporting

confidence: 87%

Covid-19 in the Oldest-old Population (80 and Older): Clinical Presentation and Prognostic Factors of Severe Disease and Mortality. A Cohort Study.

Gálvez‐Barrón

Arroyo-Huidobro

Miñarro

et al. 2020

Preprint

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BACKGROUND The oldest-old population (80 years or older) has the highest lethality from COVID-19. There is little information on the clinical presentation and specific prognostic factors for this group. This trial evaluated the clinical presentation and prognostic factors of severe disease and mortality in the oldest-old population.METHODS Ambispective cohort study of oldest-old patients hospitalized for respiratory infection associated with COVID-19 and with a positive test by real-time polymerase chain reaction. The clinical presentation and the factors associated with severe disease and mortality were evaluated (logistic regression). All patients were followed until discharge or death.RESULTS A total of 103 patients (59.2% female) were included. The most frequent symptoms were fever (68.9%), dyspnoea (60.2%), and cough (39.8%), and 11.7% presented confusion. Fifty-nine patients (57.3%) presented severe disease, and 59 died, with 43 patients (41.7%) presenting both of these. In the multivariate analysis, male sex (OR 0.31, 95% confidence interval [95% CI] 0.13-0.73, p 0.0074) and serum lactate dehydrogenase (LDH) (OR 2.55, 95% CI 1.21-5.37, p 0.0139) were associated with severe disease, and serum sodium was associated with mortality (OR 3.12, 95% CI 1.18-8.26, p 0.0222). No chronic disease or pharmacological treatment were associated with worse outcomes.CONCLUSIONS The typical presenting symptoms of respiratory infection in COVID-19 are less frequent in the oldest-old population. Male sex and LDH level are predictors of severe disease, and serum sodium level predicts of mortality in this population.

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Section: Clinical Presentationsupporting

confidence: 87%

Covid-19 in the Oldest-old Population (80 and Older): Clinical Presentation and Prognostic Factors of Severe Disease and Mortality. A Cohort Study.

Gálvez‐Barrón

Arroyo-Huidobro

Miñarro

et al. 2020

Preprint

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“…Retrospective investigations of large cohorts of hospitalised patients found that the most common symptoms in those with dementia were delirium, especially in its hypoactive variant, and altered consciousness (15,17). Similarly, Lovell et al (18) found that, among the more severe cases of COVID-19 infection admitted to palliative care units, about 30% were people with dementia and many presented with a range of neuropsychiatric symptoms, such as agitation, and delirium.…”

Section: Studies Including Older Adults With Dementiamentioning

confidence: 99%

“…Eight papers focussed on the neuropsychiatric manifestations of COVID-19 infection, 2 carried out in older adults without dementia (13,14) and 6 in older adults living with dementia, mostly due to AD aetiology (15)(16)(17)(18)(19)(20). Study designs included: one single case (13), three case series (16,19,20), two singlecentre retrospective analyses of hospital admissions (17,18) and two multi-centre investigations, one retrospective analysis of COVID-19 cases (15) and one surveillance clinical repository purposely created (14).…”

Section: Individuals With Acute Covid-19 Infectionmentioning

confidence: 99%

“…A substantial proportion of infected patients also experienced mental health problems sufficiently severe to meet criteria for a variety of new psychiatric diagnoses, as well as neurocognitive syndromes, these latter potentially unveiling ongoing latent neurodegenerative processes (14). Particularly affected were people with dementia, who presented often with agitation (16,(18)(19)(20) and altered consciousness (15,18). It is important to remark that these findings were collected in clinical environments that, during the acute phase of the crisis, hosted exclusively severe cases in need of hospitalisation.…”

Section: Neuropsychiatric Symptoms In People Who Have Contracted Covimentioning

confidence: 99%

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The Impact of COVID-19 Infection and Enforced Prolonged Social Isolation on Neuropsychiatric Symptoms in Older Adults With and Without Dementia: A Review

2020

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Background: The sudden and drastic changes due to the Coronavirus Disease 19 (COVID-19) pandemic have impacted people's physical and mental health. Clinically-vulnerable older people are more susceptible to severe effects either directly by the COVID-19 infection or indirectly due to stringent social isolation measures. Social isolation and loneliness negatively impact mental health in older adults and may predispose to cognitive decline. People with cognitive impairments may also be at high risk of worsening cognitive and mental health due to the current pandemic. This review provides a summary of the recent literature on the consequences of COVID-19, due to either viral infection or social isolation, on neuropsychiatric symptoms in older adults with and without dementia. Methods: A search was conducted in PubMed and Web of Science to identify all relevant papers published up to the 7th July 2020. Two independent assessors screened and selected the papers suitable for inclusion. Additional suitable papers not detected by literature search were manually added. Results: Fifteen articles were included: 8 focussed on the psychiatric symptoms caused by the COVID-19 infection and 7 investigated the impact of social isolation on older adults' neuropsychiatric symptoms. Four studies included older adults without dementia and 11 included patients with cognitive impairment mainly due to Alzheimer's disease. All studies found that different neuropsychiatric symptoms emerged and/or worsened in older adults with and without dementia. These changes were observed as the consequence of both COVID-19 infection and of the enforced prolonged conditions of social isolation. Cases were reported of viral infection manifesting with delirium at onset in the absence of other symptoms. Delirium, agitation and apathy were the symptoms most commonly detected, especially in people with dementia. Conclusion: The available evidence suggests that the COVID-19 pandemic has a wide negative impact on the mental well-being of older adults with and without dementia. Manca et al. Ageing and COVID-19 Neuropsychiatric Complications Viral infection and the consequent social isolation to limit its spreading have a range of neuropsychiatric consequences. Larger and more robustly designed studies are needed to clarify such effects and to assess the long-term implications for the mental health of older adults, and to test possible mitigating strategies.

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“…SARS-CoV-2 is highly contagious, due to elevated viral loads in the upper respiratory tract. The long incubation period for COVID-19 (up to 14 days) [ 5 ] associated with the fact that asymptomatic residents, visitors, and staff members [ 3 , 6 , 7 ] and residents with atypical COVID-19 symptoms [ 8 – 10 ] contribute substantially to transmission complicates the early detection of cases. This suggests that infection prevention and control (IPC) measures aimed at keeping COVID-19 out of LTCFs and early detection of SARS-CoV-2 carriers, including those who are asymptomatic and with atypical symptoms, are essential for limiting transmission in LTCFs [ 11 ].…”

Section: Specific Features Of Covid-19 Transmission In Ltcfsmentioning

confidence: 99%

August 2020 Interim EuGMS guidance to prepare European Long-Term Care Facilities for COVID-19

et al. 2020

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Purpose The European Geriatric Medicine Society (EuGMS) is launching a second interim guidance whose aim is to prevent the entrance and spread of COVID-19 into long-term care facilities (LTCFs). Methods The EuGMS gathered experts to propose a guide of measures to prevent COVID-19 outbreaks in LTCFs. It is based on the specific features of SARS-CoV-2 transmission in LTCFs, residents’ needs, and on experiences conducted in the field. Results Asymptomatic COVID-19 residents and staff members contribute substantially to the dissemination of COVID-19 infection in LTCFs. An infection prevention and control focal point should be set up in every LTCF for (1) supervising infection prevention and control measures aimed at keeping COVID-19 out of LTCFs, (2) RT-PCR testing of residents, staff members, and visitors with COVID-19 symptoms, even atypical, and (3) isolating subjects either infected or in contact with infected subjects. When a first LCTF resident or staff member is infected, a facility-wide RT-PCR test–retest strategy should be implemented for detecting all SARS-CoV-2 carriers. Testing should continue until no new COVID-19 cases are identified. The isolation of residents should be limited as much as possible and associated with measures aiming at limiting its negative effects on their mental and somatic health status. Conclusions An early recognition of symptoms compatible with COVID-19 may help to diagnose COVID-19 residents and staff more promptly. Subsequently, an earlier testing for SARS-CoV-2 symptomatic and asymptomatic LTCF staff and residents will enable the implementation of appropriate infection prevention and control. The negative effects of social isolation in residents should be limited as much as possible.

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National French Survey of Coronavirus Disease (COVID-19) Symptoms in People Aged 70 and Over

Cited by 73 publications

References 12 publications

Covid-19 in the Oldest-old Population (80 and Older): Clinical Presentation and Prognostic Factors of Severe Disease and Mortality. A Cohort Study.

Covid-19 in the Oldest-old Population (80 and Older): Clinical Presentation and Prognostic Factors of Severe Disease and Mortality. A Cohort Study.

The Impact of COVID-19 Infection and Enforced Prolonged Social Isolation on Neuropsychiatric Symptoms in Older Adults With and Without Dementia: A Review

August 2020 Interim EuGMS guidance to prepare European Long-Term Care Facilities for COVID-19

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